Jeffrey Eugene Gibbons, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP995 Issued in ID

Practice address

855 W 6TH S
Mountain Home, ID 83647-3335

Phone

(208) 587-2020

Fax

(208) 587-3349

NPI assigned

Apr 20, 2006

Last updated

Apr 4, 2017By the provider in NPPES

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

Enrolled in ID

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elmore County Eyecare, PA.Group PAC ID 6103996335, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Elmore County Eyecare, PA.

  • Optometrist
  • Mountain Home, ID
  • NPI 1003973736
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1568427615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 W 6TH S",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836473335",
            "telephone_number": "208-587-2020",
            "fax_number": "208-587-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 W 6TH S",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836473335",
            "telephone_number": "208-587-2020",
            "fax_number": "208-587-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "JEFFREY",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806081500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Weston Vern Frandsen
• Karen Anne Galvan, M.D.
• Alejandra Garcia, RDH
• Anna Marie Garvin, RN
• Darin K Gere, LCSW
• Dale Robert Gibbs, DPT
• Jacob Gibson
• Steven Gigli, DDS
• Colleen M Gingerich, LPC
• Glenns Ferry Health Center, Inc. (Desert Sage Health Centers)

• Optometrist in Mountain Home, ID
• Providers in Mountain Home, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.