Individual provider Active NPI

Kyle Thomas Gibbens, MD

  • Family Medicine Physician
  • Lincoln, NE
National Provider Identifier
1477043800
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8173 Issued in NE
Practice address
4600 Valley Rd Ste 210
Lincoln, NE 68510-4892
Phone
(402) 483-4591
Fax
(402) 483-5079
NPI assigned
May 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8173 NE Primary

Addresses

Primary practice location

4600 Valley Rd Ste 210
Lincoln, NE 68510-4892

Mailing address

4600 Valley Rd Ste 210
Lincoln, NE 68510-4892
Phone (402) 483-4591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210721003725 NE Practitioner - Family Practice 9234476961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

1601 N 86TH St
100 CHI Health Clinic
Lincoln, NE 68505-3713
Phone (402) 328-7500

16909 Lakeside Hills CT
Omaha, NE 68130-4661

Hospital & facility affiliations

  • CHI Health at Home - Lincoln Home health agency, Lincoln, NE, CCN 287050
  • CHI Health St. Elizabeth Hospital, Lincoln, NE, CCN 280020
  • Bryan Medical Center Hospital, Lincoln, NE, CCN 280003
  • CHI Health Nebraska Heart Hospital, Lincoln, NE, CCN 280128

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8173NEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
Alegent Creighton Clinic Family Medicine Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

1601 N 86th St
Ste 100
Lincoln, NE 68505
Phone (402) 327-7500

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

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.

Hospital & facility affiliations 6

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": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1477043800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 VALLEY RD STE 210",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104892",
            "telephone_number": "402-483-4591",
            "fax_number": "402-483-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 VALLEY RD STE 210",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104892",
            "telephone_number": "402-483-4591",
            "fax_number": "402-483-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBENS",
        "first_name": "KYLE",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-10",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "8173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.