Active NPI
Gibbs Wilson
- Cardiovascular Disease Physician
- Temple, TX
National Provider Identifier
1649658592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- R2254
- Practice address
- 1605 South 31St Street
Temple, TX 76508-1978 - Phone
- (254) 215-0100
- NPI assigned
- May 12, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | R2254 | TX | Primary |
| Internal Medicine Physician | 207R00000X | 593787 | TX | |
| Internal Medicine Physician | 207R00000X | R2254 | TX |
Addresses
Primary practice location
1605 South 31St Street
Temple, TX 76508-1978
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Other practice location 1
6138 Alexandria Dr
Temple, TX 76502-1978
Phone (325) 669-2069
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170621002955 | TX | Practitioner - Cardiovascular Disease (Cardiology) | 9133400385 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Texas a & M University System, HSC, College of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Hendrick Provider Network
Practice addresses (Care Compare)
1201 N 18TH St
Abilene, TX 79601-2932
Phone (325) 793-3100
Hospital & facility affiliations
- Hendrick Medical Center
- Hendrick Medical Center Brownwood
- Stephens Memorial Hospital
- Fisher County Hospital District
- Comanche County Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.51 of 100
- Quality
- 63.02
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 65.34
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 593787 | TX | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hendrick Provider Network | Current | Accepting new patients | |
| Hendrick Medical Center | Current | Accepting new patients | |
| Hendrick Provider Network | Internal Medicine | Current | Accepting new patients |
Locations
1900 Pine St
Abilene, TX 79601
Phone (325) 670-4220
1904 Pine St
Ste 4A
Abilene, TX 79601
Phone (325) 437-4020
1201 N 18th St
Abilene, TX 79601
Phone (325) 793-3300
300 E Commerce St
Brownwood, TX 76801
Phone (325) 510-3400
Interoperability endpoints
- gibbs.wilson.1@21794.direct.athenahealth.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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Abilene, TX
- NPI 1396961322
Internal Medicine, TX
-
- Rural Health Clinic/Center
- San Saba, TX
- NPI 1346044401
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Comanche, TX
- NPI 1346544616
Hospital
-
- Critical Access Hospital
- Breckenridge, TX
- NPI 1285065623
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626739200000",
"number": "1649658592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1605 SOUTH 31ST STREET",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765081978",
"telephone_number": "254-215-0100"
}
],
"practiceLocations": [
{
"address_1": "6138 Alexandria Dr",
"address_purpose": "LOCATION",
"city": "Temple",
"state": "TX",
"postal_code": "765021978",
"country_code": "US",
"telephone_number": "325-669-2069",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "GIBBS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-12",
"last_updated": "2021-07-20",
"certification_date": "2021-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "TX",
"license": "R2254",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "593787",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "R2254",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.