Organization Active NPI

Gibson Chiropractic Family Health Center

  • Chiropractor
  • Ann Arbor, MI
National Provider Identifier
1396085460
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GIBSON CHIROPRACTIC FAMILY HEALTH CENTER
Practice address
2350 Washtenaw Avenue
Suite 12
Ann Arbor, MI 48104-4525
Phone
(734) 669-8200
Fax
(734) 669-8282
NPI assigned
Feb 26, 2013
Last updated
Mar 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Authorized official

Name
Dr. Thomas H Gibson Jr., DCNPI 1942242177
Title
Owner/Director
Phone
(734) 669-8200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

2350 Washtenaw Avenue
Suite 12
Ann Arbor, MI 48104-4525

Mailing address

15151 Sharon Valley Rd
Manchester, MI 48158-9500
Phone (734) 669-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240308001228 MI Part B Supplier - Clinic/Group Practice 3375989650 Receives reassigned benefits from 1 practitioner
Practice locations: Ann Arbor, MI

National Provider Directory

National Provider Directory

Locations

2350 Washtenaw Ave
Ste 12
Ann Arbor, MI 48104
Phone (313) 779-8200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1396085460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15151 SHARON VALLEY RD",
            "city": "MANCHESTER",
            "state": "MI",
            "postal_code": "481589500",
            "telephone_number": "734-669-8200",
            "fax_number": "734-669-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 WASHTENAW AVENUE",
            "address_2": "SUITE 12",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044525",
            "telephone_number": "734-669-8200",
            "fax_number": "734-669-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBSON CHIROPRACTIC FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-26",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "734-669-8200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.