Miles Kenton Gibson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

22156 Issued in KY

Practice address

92 Joe T Petty Dr
Suite 300
Russell Springs, KY 42642-8543

Phone

(270) 866-7066

Fax

(270) 866-7068

NPI assigned

Jan 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: miles.gibson@crch.eclinicaldirectplus.com

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.

• Russell County Hospital

  • Certified Registered Nurse Anesthetist
  • Russell Springs, KY
  • NPI 1437245842
  Medicare reassignment NPD
• Russell County Hospital

  dba Primary Care Associates of Russell County

  • Rural Health Clinic/Center
  • Russell Springs, KY
  • NPI 1295245025
  NPD
• Russell County Hospital

  • Nurse Practitioner
  • Russell Springs, KY
  • NPI 1538255948

  Family Medicine

  NPD

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700857414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 JOE T. PETTEY DR.",
            "address_2": "SUITE 300",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "42642",
            "telephone_number": "270-866-7066",
            "fax_number": "270-866-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 JOE T PETTY DR",
            "address_2": "SUITE 300",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426428543",
            "telephone_number": "270-866-7066",
            "fax_number": "270-866-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "MILES",
        "middle_name": "KENTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "22156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64221567",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• ER & Associates (Southern Ky Medical Association)
• Shaina Renee Eubank, M.S., CCC-SLP
• Faith Healthcare Inc (Faith Dental of Russell Springs)
• Freedom Management (Sparc)
• Freedom Management (S.P.a.R.C.)
• Laura A Godby, LPCC
• Lisa Annette Goodlett, R.PH
• Angela Denise Gossage, PHARM.D.
• Liesel C Grentz, D.O.
• Grider Drug LLC

• Family Medicine Physician in Russell Springs, KY
• Providers in Russell Springs, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.