Individual provider Active NPI

Wendell Andrew Gibby, M.D.

  • Diagnostic Radiology Physician
  • Provo, UT
National Provider Identifier
1487090528
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
9875187-1205 Issued in UT
Practice address
3152 N University Ave Dept of
Provo, UT 84604-4745
Phone
(801) 229-2002
Fax
(202) 877-3288
NPI assigned
May 16, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 9875187-1205 UT Primary

Addresses

Primary practice location

3152 N University Ave Dept of
Provo, UT 84604-4745

Mailing address

3152 N University Ave
Provo, UT 84604-4745
Phone (801) 229-2002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, AZ, NE3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190605001110 UT Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 8123351269 Reassigns benefits to 6 organizations
I20200306002130 AZ Practitioner - Diagnostic Radiology 8123351269
I20231130002415 NE Practitioner - Diagnostic Radiology 8123351269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faith Regional Physician Services LLCGroup PAC ID 5193786168, 194 clinicians
Alpharad IncGroup PAC ID 1254367865, 3 clinicians
Riverwood Advanced Diagnostic ImagingGroup PAC ID 4385681899, 3 clinicians
Riverside Medical Center LLCGroup PAC ID 7214161256, 3 clinicians
Regional West Medical CenterGroup PAC ID 1759285885, 66 clinicians

Practice addresses (Care Compare)

2700 W Norfolk Ave
Faith Regional Health Services
Norfolk, NE 68701-4438
Phone (402) 371-4880

3152 N University Ave
Provo, UT 84604-4745
Phone (801) 229-2002

3152 N University Ave
Suite 100
Provo, UT 84604-4729
Phone (801) 229-2002

3152 N University Ave
Suite 120
Provo, UT 84604-4746
Phone (801) 375-2177

4021 Ave B
Scottsbluff, NE 69361-4602
Phone (308) 630-1111

746 S Carterville Rd
Wendell a Gibby MD
Orem, UT 84097-6642
Phone (308) 630-1111

Hospital & facility affiliations

  • Regional West Medical Center Hospital, Scottsbluff, NE, CCN 280061
  • Faith Health Hospital, Norfolk, NE, CCN 280125
  • The Nebraska Medical Center Hospital, Omaha, NE, CCN 280013
  • Box Butte General Hospital Hospital, Alliance, NE, CCN 281360
  • Community Hospital Hospital, Torrington, WY, CCN 531307

Merit-based Incentive Payment System (MIPS)

Final score
80.77 of 100Reported as group
Quality
67.03
Promoting interoperability
96
Improvement activities
40
Cost
72.22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alpharad Inc CurrentSince May 2, 2019 Accepting new patients
Gunnison Valley Hospital CurrentSince Jan 1, 2026 Accepting new patients
Riverwood Advanced Diagnostic Imaging CurrentSince Jul 16, 2020 Accepting new patients
Gunnison Valley Hospital CurrentSince Jan 1, 2026 Accepting new patients
Faith Regional Physician Services, LLC CurrentSince Oct 18, 2023 Accepting new patients
Reveal Ultrasound Studio & Spa LLC CurrentSince Aug 1, 2022 Accepting new patients
Gunnison Valley Hospital CurrentSince Jan 1, 2026 Accepting new patients
Regional West Medical Center Diagnostic Radiology CurrentSince Jul 8, 2025 Accepting new patients
Riverside Medical Center LLC CurrentSince May 2, 2019 Accepting new patients
Faith Regional Physician Services, LLC CurrentSince Oct 18, 2023 Accepting new patients
Virtual Radiologic Professionals, LLC Diagnostic Radiology Past Accepting new patients
Universal Radiology Consultants PC Diagnostic Radiology PastSince Aug 12, 2017 Accepting new patients

Locations

47452 268 Ave
Ste C
Humphrey, NE 68642
Phone (402) 923-0150

2700 W Norfolk Ave
Norfolk, NE 68701
Phone (402) 644-7131

2600 W Norfolk Ave
Ste 200
Norfolk, NE 68701
Phone (402) 844-8194

4021 Avenue B
Scottsbluff, NE 69361
Phone (308) 630-1384

46 N Main St
Manti, UT 84642
Phone (435) 835-6000

3152 N University Ave
Ste 100
Provo, UT 84604
Phone (801) 229-2002

3152 N University Ave
Provo, UT 84604
Phone (801) 229-2002

3152 N University Ave
Ste 120
Provo, UT 84604
Phone (801) 375-2177

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 5

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": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1487090528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3152 N UNIVERSITY AVE",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044745",
            "telephone_number": "801-229-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3152 N UNIVERSITY AVE DEPT OF",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044745",
            "telephone_number": "801-229-2002",
            "fax_number": "202-877-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBY",
        "first_name": "WENDELL",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-16",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "9875187-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.