Individual provider Active NPI

Richard Kimber Gibson, MD

  • Hematology & Oncology Physician
  • Grand Junction, CO
National Provider Identifier
1396721973
Registry record updated Dec 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
27395 Issued in CO
Practice address
750 Wellington Ave
Grand Junction, CO 81501-6132
Phone
(970) 298-7500
Fax
(970) 298-7262
NPI assigned
Dec 15, 2005
Last updated
Dec 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 27395 CO Primary

Addresses

Primary practice location

750 Wellington Ave
Grand Junction, CO 81501-6132

Mailing address

750 Wellington Ave
PO Box 62
Grand Junction, CO 81501-6132
Phone (970) 298-7500

Other identifiers 1

IdentifierTypeStateIssuer
01273952MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27395COMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387843200000",
    "number": "1396721973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 WELLINGTON AVE",
            "address_2": "PO BOX 62",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016132",
            "telephone_number": "970-298-7500",
            "fax_number": "970-298-7262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WELLINGTON AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016132",
            "telephone_number": "970-298-7500",
            "fax_number": "970-298-7262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "RICHARD",
        "middle_name": "KIMBER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2013-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CO",
            "license": "27395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01273952",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.