NPIMap

Organization Active NPI

Gibson Community Hospital Association

Doing business as Gibson Obstetrics and Gynecology

  • Obstetrics & Gynecology Physician
  • Gibson City, IL
National Provider Identifier
1740151034
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
GIBSON COMMUNITY HOSPITAL ASSOCIATION
Doing business as
Gibson Obstetrics and Gynecology
Practice address
201 E 8TH St
Gibson City, IL 60936-1422
Phone
(217) 784-4251
NPI assigned
Sep 17, 2025
Last updated
Oct 7, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
GIBSON COMMUNITY HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Authorized official

Name
Matthew Ertel
Title
Chief Financial Officer
Phone
(217) 784-2601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

201 E 8TH St
Gibson City, IL 60936-1422

Mailing address

1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-4251

Other names 1

  • Gibson Obstetrics and Gynecology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505001293 IL Part B Supplier - Clinic/Group Practice 5092703124 Receives reassigned benefits from 201 practitioners
38 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Watseka, IL; Urbana, IL; Paxton, IL; Fairbury, IL; Onarga, IL; Mahomet, IL; Hoopeston, IL; Gibson City, IL…

Other NPIs on the same Medicare enrollment 38

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 38

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2104974Gibson Obstetrics & Gynecology201 E 8TH St, Gibson City, IL 60936Provider-performed microscopyNov 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
The Paxton Clinic43 organizations share this tax ID, including this one
Part of
The Paxton Clinic

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Locations

201 E 8th St
Gibson City, IL 60936
Phone (217) 727-1088

NPI Registry JSON

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

{
    "created_epoch": "1758067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759795200000",
    "number": "1740151034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 N MELVIN ST",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609361477",
            "telephone_number": "217-784-4251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 8TH ST",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609361422",
            "telephone_number": "217-784-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBSON COMMUNITY HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GIBSON COMMUNITY HOSPITAL ASSOCIATION",
        "enumeration_date": "2025-09-17",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A",
        "authorized_official_last_name": "ERTEL",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "217-784-2601"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gibson Obstetrics and Gynecology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gibson City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.