Individual provider Active NPI

Michael Philip Gibson, DPT

  • Physical Therapist
  • Clinton, IA
National Provider Identifier
1447563663
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
004594 Issued in IA
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

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20100813000843 IA Practitioner - Physical Therapist in Private Practice 0941334858 Reassigns benefits to 2 organizations

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
Comprehensive Rehab IncorporatedGroup PAC ID 0840289633, 6 clinicians

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

OrganizationSpecialtyStatusNew patients
New Age Therapies PLLC Physical Therapist CurrentSince Apr 21, 2025 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.

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.

Verify at the official NPI Registry.