Active NPI
Michael Philip Gibson, DPT
- Physical Therapist
- Clinton, IA
National Provider Identifier
1447563663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 004594
- Practice address
- 1377 11TH St NW
Clinton, IA 52732-5068 - Phone
- (563) 241-4230
- Fax
- (563) 519-4235
- NPI assigned
- Jul 16, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 004594 | IA | Primary |
Addresses
Primary practice location
1377 11TH St NW
Clinton, IA 52732-5068
Mailing address
1377 11TH St NW
Clinton, IA 52732-5068
Phone (563) 241-4230
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1377 11TH St NW
Clinton, IA 52732-5068
Phone (563) 241-4230
2712 S 25TH St
Suite C
Clinton, IA 52732-7232
Phone (309) 525-1183
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Age Therapies PLLC | Physical Therapist | Current | Accepting new patients |
Locations
2712 S 25th St
Ste C
Clinton, IA 52732
Phone (309) 525-1183
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.
-
- Physical Therapist
- Clinton, IA
- NPI 1306657333
-
- Rehabilitation Clinic/Center
- Clinton, IA
- NPI 1386655272
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279238400000",
"number": "1447563663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1377 11TH ST NW",
"city": "CLINTON",
"state": "IA",
"postal_code": "527325068",
"telephone_number": "563-241-4230",
"fax_number": "563-519-4235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1377 11TH ST NW",
"city": "CLINTON",
"state": "IA",
"postal_code": "527325068",
"telephone_number": "563-241-4230",
"fax_number": "563-519-4235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "MICHAEL",
"middle_name": "PHILIP",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-16",
"last_updated": "2010-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "004594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clinton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.