Individual provider Active NPI

Jennifer D Gibson, MD

  • Pediatrics Physician
  • Lancaster, OH
National Provider Identifier
1528039203
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35071791 Issued in OH
Practice address
401 N Ewing St
Lancaster, OH 43130-3372
Phone
(740) 687-8000
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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 35 07 1791 G OH
Hospitalist Physician 208M00000X 35071791 OH
Pediatrics Physician 208000000X 35071791 OH Primary

Addresses

Primary practice location

401 N Ewing St
Lancaster, OH 43130-3372

Mailing address

700 Childrens Dr Ste 200
Columbus, OH 43205-2664
Phone (614) 722-2000

Other identifiers 1

IdentifierTypeStateIssuer
2160370MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110412000565 OH Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Pediatric Medicine 4587553425 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35 07 1791 GOHMDInternal Medicine Physician
35071791OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Academic Association, Inc. Pediatrics CurrentSince Jul 1, 2019 Accepting new patients
Ohio State University - Cap Internal Medicine PastSince Oct 1, 2021 Accepting new patients
Osu Internal Medicine, LLC Internal Medicine Past Accepting new patients
Fairfield Medical Center Past Accepting new patients

Locations

700 Childrens Dr
Ste 200
Columbus, OH 43205

Dept L289
Columbus, OH 43260

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

401 N Ewing St
Lancaster, OH 43130
Phone (740) 687-8000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/f17aed19-e2f6-49d4-bba0-64508a2357d2/

Organizations & group practices 5

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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1528039203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N EWING ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303372",
            "telephone_number": "740-687-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35 07 1791 G",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35071791",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35071791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2160370",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.