Phillip Roy Gilbertson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2459A Issued in WY

Practice address

8204 Wyoming Hwy 789
Lander, WY 82520-2945

Phone

(307) 335-6716

Fax

(307) 335-6991

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1366538076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8204 WYOMING HIGHWAY 789",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825202941",
            "telephone_number": "307-335-6716",
            "fax_number": "307-335-6991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8204 WYOMING HWY 789",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825202945",
            "telephone_number": "307-335-6716",
            "fax_number": "307-335-6991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERTSON",
        "first_name": "PHILLIP",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "2459A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105078800",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD RETIRE",
            "identifier": "080035569",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "301811",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gannett Peak Physical Medicine LLC
• Ashleigh Gardner
• Lindsey Gauderer
• Wendy Michelle Gebhart, N.D., LAC
• Brian Dale Gee, MD
• Mark Gilliland, M.DIV
• Aven Garms Glazer, CPNP
• Heather Glenn Gray, PA-C
• Gregory P Clifford MD PC
• Amber Grogan, PHARM D

• Family Medicine Physician in Lander, WY
• Providers in Lander, WY by specialty
• Family Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.