Wendy S. Gibson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

911DT Issued in KY

Practice address

1512 Main St
Benton, KY 42025-1607

Phone

(270) 527-0951

Fax

(270) 527-1316

NPI assigned

Nov 21, 2006

Last updated

Nov 14, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

University of Houston - College of Optometry, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wendy Sowell Gibson OD

  • Optometrist
  • Benton, KY
  • NPI 1114121324
  Medicare reassignment NPD Authorized official
• Marshall County Hospital District

  dba Marshall County Surgical & Medical Group

  • Rural Health Clinic/Center
  • Benton, KY
  • NPI 1962873109
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384387200000",
    "number": "1649345190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 MAIN ST",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420251607",
            "telephone_number": "270-527-0951",
            "fax_number": "270-527-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 MAIN ST",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420251607",
            "telephone_number": "270-527-0951",
            "fax_number": "270-527-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "WENDY",
        "middle_name": "S.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2013-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "KY",
            "license": "911DT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "911DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77009116",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Forte Family Practice PLLC
• Louis Forte, MD
• Kimberly Jill Frick, PT
• Ellie Fulgham
• Cassie Garrison, OTR/L
• Leigh S Gideon, DC
• Rhonda Goins, RPH
• Goldsboro Surgical Associates, PA
• Toni Shantel Gordon-Bailey, APRN
• Michael D Gordon, APRN

• Optometrist in Benton, KY
• Providers in Benton, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; 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.