Russell Gibson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD18195 Issued in TN

Practice address

129 Montgomery LN
Maryville, TN 37803-5649

Phone

(865) 681-1224

Fax

(865) 681-5185

NPI assigned

May 11, 2006

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

Other names 1

• Dr. Ernest Russell Gibson Other name

Medicare fee-for-service enrollment

Enrolled in TN

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

Family Practice

Education

East Tennessee State University Quillen College of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Blount Memorial Hospital Hospital, Maryville, TN, CCN 440011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Appalachian Development LLC

  • Family Medicine Physician
  • Maryville, TN
  • NPI 1184740763
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prisma Health - Blount Memorial Hospital Inc.

  • General Acute Care Hospital
  • Maryville, TN
  • NPI 1619939071
  Care Compare affiliation

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821048638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 MONTGOMERY LN",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378035649",
            "telephone_number": "865-681-1224",
            "fax_number": "865-681-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 MONTGOMERY LN",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378035649",
            "telephone_number": "865-681-1224",
            "fax_number": "865-681-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD18195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0119209",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERNEST",
            "last_name": "GIBSON",
            "middle_name": "RUSSELL",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Katlyn Gettelfinger, PHARMD
• Erin Cummins Giacomini, D.M.D.
• Kelle Gibbs
• Erin Alyse Giblin, FNP
• Juli Anna Stanford Gibson, BSN, RN; C-EFM; CBS
• Ashton Paige Gildner, COTA/L
• James H. Gillespie, DDS
• Jerry M Gilley, MD
• Monica Tain Ginart, DMD, MS
• Lauren Going, SLP

• Family Medicine Physician in Maryville, TN
• Providers in Maryville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.