Individual provider Active NPI

Paige Katherine Gibson, PA-C

  • Physician Assistant
  • Jackson, MI
National Provider Identifier
1679315139
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2195 Spring Arbor Rd
Jackson, MI 49203-2878
Phone
(517) 539-6111
NPI assigned
Jun 6, 2024
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2195 Spring Arbor Rd
Jackson, MI 49203-2878

Mailing address

572 Beacon Lake Dr Apt 5
Mason, MI 48854-2901
Phone (517) 672-0650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260515003446 MI Practitioner - Physician Assistant 6406325646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2195 Spring Arbor Rd
Jackson, MI 49203-2878

611 E Columbia St
Mason, MI 48854-1303

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brad E Kremer PLLC CurrentSince Jun 9, 2024 Accepting new patients
Garcia Clinical Laboratory Inc PastSince Jun 9, 2024 Accepting new patients

Locations

2195 Spring Arbor Rd
Jackson, MI 49203
Phone (517) 539-6111

Interoperability endpoints

  • Direct secure messaging: ppokriefka1026952@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1679315139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "572 BEACON LAKE DR APT 5",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488542901",
            "telephone_number": "517-672-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 SPRING ARBOR RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492032878",
            "telephone_number": "517-539-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "PAIGE",
        "middle_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-06",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.