Active NPI
Jenner Gibson, M.D.
- Family Medicine Physician
- Sanford, ME
National Provider Identifier
1902286131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD27892
- Practice address
- 25A June St
Sanford, ME 04073-2642 - Phone
- (207) 490-7998
- NPI assigned
- Jun 3, 2015
- Sex
- Male
- Sole proprietor
- No
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 | MD27892 | ME | Primary |
Addresses
Primary practice location
25A June St
Sanford, ME 04073-2642
Mailing address
25A June St
Sanford, ME 04073-2642
Phone (207) 490-7998
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Wake Forest University School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
25 A June St
Sanford, ME 04073-2642
Hospital & facility affiliations
- Mainehealth Home Health and Hospice
- Wentworth Home Care & Hospice, an Amedisys Partner
- Cornerstone Vna
- Andwell Health Partners
- Mainehealth Maine Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Family Medicine | Past | Accepting new patients |
Locations
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
25A June St
Ste 111
Sanford, ME 04073
Phone (207) 324-5968
25A June St
Sanford, ME 04073
Phone (207) 324-8311
Interoperability endpoints
- jgibson877962@direct.mmc.mainehealth.org
Organizations & group practices 4
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.
-
- Psychiatric Hospital
- Westbrook, ME
- NPI 1790265502
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- Obstetrics & Gynecology Physician
- Portland, ME
- NPI 1679887277
Hospital & facility affiliations 41
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Community Based Hospice Care Agency
- Scarborough, ME
- NPI 1972594232
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721692800000",
"number": "1902286131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25A JUNE ST",
"city": "SANFORD",
"state": "ME",
"postal_code": "040732642",
"telephone_number": "207-490-7998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25A JUNE ST",
"city": "SANFORD",
"state": "ME",
"postal_code": "040732642",
"telephone_number": "207-490-7998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "JENNER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-03",
"last_updated": "2024-07-23",
"certification_date": "2024-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ME",
"license": "MD27892",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sanford, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.