Individual provider Active NPI

Corinne Gibbons, MD

  • Family Medicine Physician
  • Lawrence, MA
National Provider Identifier
1568022986
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1013178 Issued in MA
Practice address
34 Haverhill St
Lawrence, MA 01841-2884
Phone
(978) 686-0090
NPI assigned
Jun 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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 1013178 MA Primary

Addresses

Primary practice location

34 Haverhill St
Lawrence, MA 01841-2884

Mailing address

34 Haverhill St
Lawrence, MA 01841-2884
Phone (978) 686-0090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20230613001136 MA Practitioner - Family Practice 5890020960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Massachusetts Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19 Tacoma St
Worcester, MA 01605-3516
Phone (508) 852-1805

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1013178MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Jun 15, 2023 Accepting new patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Jun 15, 2023 Accepting new patients
Edward M. Kennedy Community Health Center, Inc Past Accepting new patients

Locations

354 Waverley St
Framingham, MA 01702
Phone (508) 270-5700

41 Cape Rd
Milford, MA 01757
Phone (508) 270-5750

605 Lincoln St
Worcester, MA 01605
Phone (508) 856-0104

650 Lincoln St
Worcester, MA 01605
Phone (508) 532-7318

19 Tacoma St
Worcester, MA 01605
Phone (508) 854-2122

Interoperability endpoints

  • Direct secure messaging: corinne.gibbons.p1@direct.emkchc.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1568022986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 HAVERHILL ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412884",
            "telephone_number": "978-686-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 HAVERHILL ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412884",
            "telephone_number": "978-686-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "CORINNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "1013178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.