Willie B Gibson, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

4301035487 Issued in MI

Practice address

18300 W McNichols Rd
Detroit, MI 48219-4162

Phone

(313) 535-9366

Fax

(313) 534-1970

NPI assigned

Jan 28, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Oakwood Professional Billing, LLC

  • General Practice Physician
  • Detroit, MI
  • NPI 1457641011
  NPD (past)

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260057600000",
    "number": "1497801609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18300 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482194162",
            "telephone_number": "313-535-9366",
            "fax_number": "313-534-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482194162",
            "telephone_number": "313-535-9366",
            "fax_number": "313-534-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "WILLIE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-28",
        "last_updated": "2009-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301035487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1098127",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole E Gibson
• Rita Zonia Gibson, LMSW
• Samara Denise Gibson, M.D.
• Satrina Gibson
• Veronica Warren Gibson, M.A., LLPC
• Harish Harry Gidda, MD
• Marina Giertz, LLMSW
• Cher Rennie Gieseking, FNP-BC
• John Gietzen, M.D.
• Michael G Gifford, MD

• Endocrinology, Diabetes & Metabolism Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Endocrinology, Diabetes & Metabolism Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.