Individual provider Active NPI

John Charles Gibbons, DO

  • Physical Medicine & Rehabilitation Physician
  • Indianapolis, IN
National Provider Identifier
1902398845
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
02006812A Issued in IN
Practice address
6330 E 75TH St Ste 110
Indianapolis, IN 46250-2717
Phone
(317) 588-7130
Fax
(317) 813-1346
NPI assigned
Jun 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 02006812A IN Primary

Addresses

Primary practice location

6330 E 75TH St Ste 110
Indianapolis, IN 46250-2717

Mailing address

6330 E 75TH St Ste 110
Indianapolis, IN 46250-2717
Phone (317) 588-7130

Other identifiers 1

IdentifierTypeStateIssuer
300064032MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgibbons@directaddress.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20220629001893 IN Practitioner - Physical Medicine and Rehabilitation 3577943125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rehabilitation Associates of in PCGroup PAC ID 1557256740, 7 clinicians

Practice addresses (Care Compare)

6330 E 75TH St
Suite 110
Indianapolis, IN 46250-2717
Phone (317) 588-7130

Hospital & facility affiliations

  • Community Hospital South, Inc. Hospital, Indianapolis, IN, CCN 150128
  • Community Hospital East Hospital, Indianapolis, IN, CCN 150074
  • Columbus Regional Hospital Hospital, Columbus, IN, CCN 150112
  • Franciscan Health Indianapolis Hospital, Indianapolis, IN, CCN 150162
  • Community Health Network Rehabilitation Hosp So Inpatient rehabilitation facility, Greenwood, IN, CCN 153044

Merit-based Incentive Payment System (MIPS)

Final score
97.51 of 100Reported as group
Quality
84.51
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
02006812AINMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Associates of in PC Physical Medicine & Rehabilitation CurrentSince Jul 11, 2022 Accepting new patients
Major Hospital Past Accepting new patients

Locations

6330 E 75th St
Ste 110
Indianapolis, IN 46250
Phone (317) 588-7130

7950 N Shadeland Ave
Ste 100
Indianapolis, IN 46250
Phone (317) 588-7130

Interoperability endpoints

  • Direct secure messaging: jgibbons@directaddress.net

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1902398845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 E 75TH ST STE 110",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502717",
            "telephone_number": "317-588-7130",
            "fax_number": "317-813-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 E 75TH ST STE 110",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502717",
            "telephone_number": "317-588-7130",
            "fax_number": "317-813-1346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "02006812A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300064032",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgibbons@directaddress.net",
            "affiliation": "N",
            "endpointDescription": "direct email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6330 E 75th St Ste 110",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.