NPIMap

Individual provider Active NPI

Rebecca Joy Gibson, NP

  • Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1346863354
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9312 Issued in MN
Practice address
1415 Lilac Dr N Ste 190
Minneapolis, MN 55422-4544
Phone
(763) 267-8701
Fax
(763) 231-9602
NPI assigned
May 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2429100 MN
Nurse Practitioner 363L00000X 9312 MN Primary

Addresses

Primary practice location

1415 Lilac Dr N Ste 190
Minneapolis, MN 55422-4544

Mailing address

1415 Lilac Dr N Ste 190
Golden Valley, MN 55422-4544
Phone (763) 267-8701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221026000406 MN Practitioner - Nurse Practitioner 6002282423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Twin Cities Physicians Professional CorporationGroup PAC ID 9830499763, 66 clinicians

Practice addresses (Care Compare)

1415 Lilac Dr N
Suite 190
Golden Valley, MN 55422-4544
Phone (763) 267-8701

Hospital & facility affiliations

  • Adara Home Health Inc Home health agency, Buffalo, MN, CCN 248056
  • Brighton Hospice Hospice, Saint Louis Park, MN, CCN 241594
  • Grace Hospice Hospice, Minneapolis, MN, CCN 241595
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • Saint Therese at Oxbow Lake Nursing home, Brooklyn Park, MN, CCN 245619

Merit-based Incentive Payment System (MIPS)

Final score
86.11 of 100Reported as group
Quality
70.97
Improvement activities
40
Cost
73.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2429100MNMDRegistered Nurse
9312MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Cities Physicians Professional Corporation Nurse Practitioner CurrentSince Aug 15, 2022 Accepting new patients
Saint Therese of Oxbow Lake, LLC Past Accepting new patients

Locations

1415 Lilac Dr N
Ste 190
Minneapolis, MN 55422
Phone (763) 267-8701

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1346863354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 LILAC DR N STE 190",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224544",
            "telephone_number": "763-267-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 LILAC DR N STE 190",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554224544",
            "telephone_number": "763-267-8701",
            "fax_number": "763-231-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "REBECCA",
        "middle_name": "JOY",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2429100",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "9312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.