Individual provider Active NPI

Paul D Gibb, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Spokane Valley, WA
National Provider Identifier
1811905920
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MD00015513 Issued in WA
Practice address
1215 N McDonald Rd
Ste 101
Spokane Valley, WA 99216-1048
Phone
(509) 924-1950
Fax
(509) 921-0017
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD00015513 WA Primary

Addresses

Primary practice location

1215 N McDonald Rd
Ste 101
Spokane Valley, WA 99216-1048

Mailing address

1215 N McDonald Rd
Ste 101
Spokane Valley, WA 99216-1048
Phone (509) 924-1950

Other identifiers 2

IdentifierTypeStateIssuer
1179308MedicaidWA
910987719OtherWAPREMERA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
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

LicenseStateTypeSpecialty
MD00015513WAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spokane Internal Medicine, P.S. Geriatric Medicine Current Accepting new patients

Locations

1215 N McDonald Rd
Ste 101
Spokane Valley, WA 99216
Phone (509) 924-1950

1215 N McDonald Rd
Spokane Valley, WA 99216
Phone (509) 598-7750

1215 N McDonald Rd
Ste 1
Spokane Valley, WA 99216

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1811905920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 N MCDONALD RD",
            "address_2": "STE 101",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161048",
            "telephone_number": "509-924-1950",
            "fax_number": "509-921-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 N MCDONALD RD",
            "address_2": "STE 101",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161048",
            "telephone_number": "509-924-1950",
            "fax_number": "509-921-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBB",
        "first_name": "PAUL",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WA",
            "license": "MD00015513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1179308",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA",
            "identifier": "910987719",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.