Susan M Gibson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21115 Issued in AL

Practice address

3840 Gault Ave N
Fort Payne, AL 35967-5211

Phone

(256) 844-4975

Fax

(256) 844-4978

NPI assigned

Aug 21, 2006

Last updated

Jul 20, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

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.

• Highlands Hospitalists Services LLC

  • Hospitalist Physician
  • Scottsboro, AL
  • NPI 1154690246
  Medicare reassignment NPD
• Premier Medical Clinic LLC

  • Multi-Specialty Clinic/Center
  • Scottsboro, AL
  • NPI 1083955173
  Medicare reassignment NPD
• Quality of Life Health Services Inc

  dba Quality of Life Health Complex

  • Community Health Clinic/Center
  • Gadsden, AL
  • NPI 1447200977
  Medicare reassignment NPD
• Quality of Life Health Services, Inc

  dba Cleburne Quality Health Care

  • Federally Qualified Health Center (FQHC)
  • Heflin, AL
  • NPI 1467620989
  NPD
• Quality of Life Health Services, Inc.

  dba J W Stewart Neighborhood Health Center

  • Community Health Clinic/Center
  • Gadsden, AL
  • NPI 1750332243
  NPD
• Whatley Health Services Inc

  dba Maude L. Whatley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Tuscaloosa, AL
  • NPI 1063422756
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1720194087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 TAYLOR ST",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357682421",
            "telephone_number": "256-259-5313",
            "fax_number": "256-259-4923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 GAULT AVE N",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359675211",
            "telephone_number": "256-844-4975",
            "fax_number": "256-844-4978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "21115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gadsden Hearing Aid, Inc. (Wright Hearing Center)
• Lyza Tennille Gaines, CRNP
• Justin Matthew Garmany, RPH
• Sarah Baine Genelin
• General Dentistry and Same Day Denture Clinic,LLC
• Go Play Therapy Center, LLC
• Go Play Therapy, L.L.C.
• Lisa Diane Goldman, P.T., DPT
• Anna Gorham, FNP-C, PMHNP-C
• Joleen Wiener Gorman, MD

• Family Medicine Physician in Fort Payne, AL
• Providers in Fort Payne, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; 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.