Mark William Gibson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1130 Issued in ID

Practice address

7A Reich Street
Marsing, ID 83639-0252

Phone

(208) 896-5520

Fax

(208) 896-9920

NPI assigned

Jun 17, 2005

Last updated

Mar 10, 2008By 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 ID

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Mna Gibson P.C.

  • Chiropractor
  • Marsing, ID
  • NPI 1316117005
  Medicare reassignment NPD Authorized official
• Intermountain Chiropractic

  • Chiropractor
  • Boise, ID
  • NPI 1881631208
  NPD (past)

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1720083439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 252",
            "address_2": "7A REICH ST.",
            "city": "MARSING",
            "state": "ID",
            "postal_code": "836390252",
            "telephone_number": "208-921-1781",
            "fax_number": "208-896-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7A REICH STREET",
            "city": "MARSING",
            "state": "ID",
            "postal_code": "836390252",
            "telephone_number": "208-896-5520",
            "fax_number": "208-896-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8078441",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Leigh Coltrin, LMSW
• Community Health Clinics, Inc. (Terry Reilly Health Services)
• Community Health Clinics, Inc. (Terry Reilly Health Services)
• Community Health Clinics, Inc. (Terry Reilly Health Services)
• Community Health Clinics, Inc. (Terry Reilly Health Services)
• Madisyn Marie Hanson
• His Love
• Troy A Landes, PA
• Marsing Ambulance EMS District
• Marsing Ambulance Service Inc (Marsing Ambulance)

• Chiropractor in Marsing, ID
• Providers in Marsing, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.