Individual provider Active NPI

Donald E Gibbons III, MD

  • Emergency Medicine Physician
  • Lewisville, TX
National Provider Identifier
1720019623
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M4791 Issued in TX
Practice address
500 W Main St
Emergency Department
Lewisville, TX 75057-3629
Phone
(972) 420-1000
NPI assigned
Jul 6, 2006
Last updated
Aug 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 336077005 IL
Emergency Medicine Physician 207P00000X M4791 TX Primary

Addresses

Primary practice location

500 W Main St
Emergency Department
Lewisville, TX 75057-3629

Mailing address

758 N Larrabee St
Apt. 514
Chicago, IL 60610-6445
Phone (773) 710-1654

Other identifiers 4

IdentifierTypeStateIssuer
P00364135OtherTXRAILROAD
183312101MedicaidTX
8W0733OtherTXBCBS
183312102MedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070124000139 TX Practitioner - Emergency Medicine 5698776300 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Associates of Central Texas PAGroup PAC ID 6800147216, 32 clinicians

Practice addresses (Care Compare)

850 W Central Texas Expy
Harker Heights, TX 76548-1890
Phone (254) 690-0900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
336077005ILMDEmergency Medicine Physician
M4791TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ies Carrollton PLLC Emergency Medicine CurrentSince Aug 15, 2022 Accepting new patients
Emergency Associates of Central Texas PA Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Legacy Urgent Care, PA CurrentSince Nov 1, 2022 Accepting new patients

Locations

4343 N Josey Ln
Carrollton, TX 75010
Phone (972) 394-2280

330 S Denton Tap Rd
Coppell, TX 75019
Phone (469) 312-7777

9205 Legacy Dr
Frisco, TX 75033
Phone (972) 625-6020

850 W Central Texas Expy
Killeen, TX 76548
Phone (254) 690-0900

2810 S Hardin Blvd
Ste 100
McKinney, TX 75072
Phone (972) 548-7277

8950 N Tarrant Pkwy
North Richlnd Hls, TX 76182
Phone (817) 281-7277

Interoperability endpoints

  • Direct secure messaging: dgibbons864327@ahs.direct-ci.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, 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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1720019623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 N LARRABEE ST",
            "address_2": "APT. 514",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606106445",
            "telephone_number": "773-710-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750573629",
            "telephone_number": "972-420-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "DONALD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "336077005",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "M4791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00364135",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183312101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8W0733",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183312102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

Verify at the official NPI Registry.