NPIMap

Individual provider Active NPI

Ronald Oscar Gibbons, M.D., MBA

  • Nephrology Physician
  • Odessa, TX
National Provider Identifier
1598828824
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
N0787 Issued in TX
Practice address
318 N Alleghaney Ave
Suite 200
Odessa, TX 79761-5052
Phone
(432) 558-0497
Fax
(432) 558-0498
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X N0787 TX Primary
Internal Medicine Physician 207R00000X N0787 TX

Addresses

Primary practice location

318 N Alleghaney Ave
Suite 200
Odessa, TX 79761-5052

Mailing address

3323 N Midland Dr
Suite 113-106
Midland, TX 79707-4608
Phone (432) 558-0497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070507000572 TX Practitioner - NephrologyPractitioner - Internal Medicine 5698871713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

318 N Alleghaney Ave
Suite 200
Odessa, TX 79761-5027
Phone (432) 558-0497

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N0787TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Odessa Internal Medicine Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1598828824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3323 N MIDLAND DR",
            "address_2": "SUITE 113-106",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797074608",
            "telephone_number": "432-558-0497",
            "fax_number": "432-558-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 N ALLEGHANEY AVE",
            "address_2": "SUITE 200",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615052",
            "telephone_number": "432-558-0497",
            "fax_number": "432-558-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "RONALD",
        "middle_name": "OSCAR",
        "name_prefix": "Dr.",
        "credential": "M.D., MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "N0787",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N0787",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.