Individual provider Active NPI

Shari Lynn Gibson, MD

  • Family Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1902814916
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17146 Issued in AZ
Practice address
5111 N Scottsdale Rd
Suite 201
Scottsdale, AZ 85250-7075
Phone
(480) 656-7654
Fax
(480) 656-8718
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 17146 AZ Primary

Addresses

Primary practice location

5111 N Scottsdale Rd
Suite 201
Scottsdale, AZ 85250-7075

Mailing address

5111 N Scottsdale Rd
Suite 201
Scottsdale, AZ 85250-7075
Phone (480) 656-7654

Other identifiers 2

IdentifierTypeStateIssuer
AZ0252830OtherAZBCBS OF ARIZONA
2239489OtherAZCIGNA HEALTH CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20100828000103 AZ Practitioner - Family Practice 6608990551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5111 N Scottsdale Rd
Suite 201
Scottsdale, AZ 85250-7077
Phone (480) 656-7654

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Family Medicine P.C. Family Medicine CurrentSince Sep 23, 2010 Accepting new patients
Hayden Family Medical Center LTD Family Medicine Past Accepting new patients

Locations

5111 N Scottsdale Rd
Ste 201
Scottsdale, AZ 85250
Phone (480) 656-7654

Interoperability endpoints

  • Direct secure messaging: shari.gibson@gfmaz.directbygreenway.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71692

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1902814916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 N SCOTTSDALE RD",
            "address_2": "SUITE 201",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852507075",
            "telephone_number": "480-656-7654",
            "fax_number": "480-656-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 N SCOTTSDALE RD",
            "address_2": "SUITE 201",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852507075",
            "telephone_number": "480-656-7654",
            "fax_number": "480-656-8718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SHARI",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "17146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ARIZONA",
            "identifier": "AZ0252830",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH CARE",
            "identifier": "2239489",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.