Individual provider Active NPI

Meredith Lynn Gibbons, DO

  • Hospitalist Physician
  • Hemet, CA
National Provider Identifier
1447679964
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
OP61055810 Issued in WA
Practice address
1117 E Devonshire Ave
Hemet, CA 92543-3083
Phone
(951) 652-2811
NPI assigned
Apr 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OP61055810 WA
Hospitalist Physician 208M00000X OP61055810 WA Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 20A15633 CA

Addresses

Primary practice location

1117 E Devonshire Ave
Hemet, CA 92543-3083

Mailing address

11315 Bridgeport Way SW
Lakewood, WA 98499-3004
Phone (253) 426-6341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200129001789 CA Practitioner - Internal MedicinePractitioner - Hospitalist 9739407008
I20200928002952 WA Practitioner - HospitalistPractitioner - Internal Medicine 9739407008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

11315 Bridgeport Way SW
Lakewood, WA 98499-3004
Phone (253) 426-6341

Hospital & facility affiliations

  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021
  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15633CAMDClinical Social Worker
20A15633CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Multi-Specialty CurrentSince Aug 17, 2020 Accepting new patients
Franciscan Medical Group Multi-Specialty CurrentSince Aug 17, 2020 Accepting new patients
Franciscan Medical Group Multi-Specialty Current Accepting new patients

Locations

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1397174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1447679964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11315 BRIDGEPORT WAY SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993004",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 E DEVONSHIRE AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433083",
            "telephone_number": "951-652-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "MEREDITH",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-11",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "OP61055810",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "OP61055810",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A15633",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

Verify at the official NPI Registry.