Active NPI
James M. Gibson, MD
- Family Medicine Physician
- Denver, CO
National Provider Identifier
1861536575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 28554
- Practice address
- 1020 15TH St
Unit 26-a
Denver, CO 80202-2300 - Phone
- (970) 547-3593
- NPI assigned
- Feb 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 28554 | CO | Primary |
Addresses
Primary practice location
1020 15TH St
Unit 26-a
Denver, CO 80202-2300
Mailing address
PO Box 7399
PMB 195
Breckenridge, CO 80424-7399
Phone (970) 547-3593
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01285543 | Medicaid | CO |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28554 | CO | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286236800000",
"number": "1861536575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7399",
"address_2": "PMB 195",
"city": "BRECKENRIDGE",
"state": "CO",
"postal_code": "804247399",
"telephone_number": "970-547-3593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 15TH ST",
"address_2": "UNIT 26-A",
"city": "DENVER",
"state": "CO",
"postal_code": "802022300",
"telephone_number": "970-547-3593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "JAMES",
"middle_name": "M.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-16",
"last_updated": "2010-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "28554",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01285543",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.