Michael Anthony Gibson Sr., M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

057975 Issued in GA

Practice address

3969 S Cobb Dr SE
Suite 201
Smyrna, GA 30080-6358

Phone

(770) 438-2942

NPI assigned

Jul 10, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Internal Medicine

Education

Medical College of Georgia School of Medicine, 2004

Medicare assignment

May accept Medicare assignment

Group practices

The Good Samaritan Health Center, Inc.Group PAC ID 4082509682, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.gibson.1@6806.direct.athenahealth.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.

• The Good Samaritan Health Center, Inc.

  • Primary Care Clinic/Center
  • Atlanta, GA
  • NPI 1629254008
  Medicare reassignment Care Compare group NPD
• Integrated Health and Wellness, LLC

  • Internal Medicine Physician
  • Decatur, GA
  • NPI 1235632282
  NPD Authorized official
• Pristine Healthcare

  • Health Service Clinic/Center
  • Villa Rica, GA
  • NPI 1225477102
  NPD (past) Authorized official
• Hope First Investments

  dba Hope 1st Pharmacy

  • Pharmacy
  • Atlanta, GA
  • NPI 1861114977
  NPD (past)
• Theradox

  • Multi-Specialty Clinic/Center
  • East Point, GA
  • NPI 1811304884
  NPD (past)

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1750589891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 SERENITY POINT LN",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301806963",
            "telephone_number": "404-580-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3969 S COBB DR SE",
            "address_2": "SUITE 201",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806358",
            "telephone_number": "770-438-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "057975",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "057975",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA. LICENSE",
            "identifier": "057975",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georgia Urology, PA
• Georgia Urology, PA
• Suthikan Gerlach
• Fariba Ghaderpanah
• Mary Christine Giattina, LCSW
• Giddens Development Group, LLC (Caring Senior Service Atlanta North)
• Janette Black Gilbert, LCSW
• Alexander Lance Giles, FNP
• Heather Gillanders, COTA
• Dannell Gillespie, PHARMD

• Internal Medicine Physician in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• 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.