Individual provider Active NPI

Robert Vanderhyde Gibbons, M.D.

  • Internal Medicine Physician
  • Jbsa Ft Sam Houston, TX
National Provider Identifier
1629430178
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD051461L Issued in PA
Practice address
3698 Chambers Pass BLDG 3611
US Army Institute of Surgical Research
Jbsa Ft Sam Houston, TX 78234-7766
Phone
(210) 636-4424
NPI assigned
Mar 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD051461L PA Primary

Addresses

Primary practice location

3698 Chambers Pass BLDG 3611
US Army Institute of Surgical Research
Jbsa Ft Sam Houston, TX 78234-7766

Mailing address

3698 Chambers Pass BLDG 3611
US Army Institute of Surgical Research
Jbsa Ft Sam Houston, TX 78234-7766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD051461LPAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1629430178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3698 CHAMBERS PASS BLDG 3611",
            "address_2": "US ARMY INSTITUTE OF SURGICAL RESEARCH",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3698 CHAMBERS PASS BLDG 3611",
            "address_2": "US ARMY INSTITUTE OF SURGICAL RESEARCH",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347766",
            "telephone_number": "210-636-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "ROBERT",
        "middle_name": "VANDERHYDE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD051461L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Ft Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.