Active NPI
Jeremy Brendon Gibson, D.O.
- Anatomic Pathology & Clinical Pathology Physician
- Rochester, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 55625
- Practice address
- 1650 4TH St SE
Rochester, MN 55904-4717 - Phone
- (507) 529-6616
- Fax
- (507) 529-6622
- NPI assigned
- Jan 19, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 02007660A | IN | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | C3863 | KY | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 55625 | MN | Primary |
Addresses
Primary practice location
1650 4TH St SE
Rochester, MN 55904-4717
Mailing address
1650 4TH St SE
Rochester, MN 55904-4717
Phone (507) 529-6616
Other practice location 1
250 Park St
Bowling Green, KY 42101-1760
Phone (270) 745-1264
Other practice location 2
7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-2856
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IN, KY, TN, KS, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 6
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- Kansas City University of Med & Biosciences, College of Osteo Med, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1010 Airpark Ctr Dr
Nashville, TN 37217-5200
Phone (615) 221-4400
250 Park St
Bowling Green, KY 42101-1760
Phone (270) 745-1000
401 Woodland Hills Blvd
Fort Scott, KS 66701-8797
Phone (417) 502-3840
7950 W Jefferson Blvd
Fort Wayne, IN 46804-4160
Phone (615) 221-4447
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55625 | MN | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Pathologists, LLC | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
| Citizens Memorial Hospital District | Current | Accepting new patients | |
| Citizens Memorial Hospital District | Current | Accepting new patients | |
| Associated Pathologists LLC | Past | Accepting new patients |
Locations
7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088
401 Woodland Hills Blvd
Fort Scott, KS 66701
Phone (620) 223-2200
1201 E Centennial Dr
Pittsburg, KS 66762
Phone (620) 231-0204
1801 Ashley Cir
Bowling Green, KY 42104
Phone (270) 781-4330
250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000
1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000
5301 Virginia Way
Ste 300
Brentwood, TN 37027
Phone (615) 695-4977
1010 Airpark Center Dr
Nashville, TN 37217
Phone (615) 221-4447
Organizations & group practices 5
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.
-
dba Associated Pathologists LLC dba PathGroup
- Anatomic Pathology & Clinical Pathology Physician
- Nashville, TN
- NPI 1003863580
IN, KS, KY
-
- Emergency Medicine Physician
- Bolivar, MO
- NPI 1558548818
-
- Anatomic Pathology & Clinical Pathology Physician
- Dallas, TX
- NPI 1265477707
-
dba CMH Buffalo Community Pharmacy
- Community/Retail Pharmacy
- Buffalo, MO
- NPI 1427480995
-
dba Anatomic Pathology Lab
- Clinical Medical Laboratory
- Nashville, TN
- NPI 1124075635
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Decatur, IN
- NPI 1689696148
-
dba Lutheran Hospital of Indiana
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1306897335
-
dba Owensboro Health Regional Hospital
- General Acute Care Hospital
- Owensboro, KY
- NPI 1285613612
-
dba Lutheran Kosciusko Hospital
- General Acute Care Hospital
- Warsaw, IN
- NPI 1164475711
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756339200000",
"number": "1912987504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 4TH ST SE",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559044717",
"telephone_number": "507-529-6616",
"fax_number": "507-529-6622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 4TH ST SE",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559044717",
"telephone_number": "507-529-6616",
"fax_number": "507-529-6622"
}
],
"practiceLocations": [
{
"address_1": "250 Park St",
"address_purpose": "LOCATION",
"city": "Bowling Green",
"state": "KY",
"postal_code": "421011760",
"country_code": "US",
"telephone_number": "270-745-1264",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7950 W Jefferson Blvd",
"address_purpose": "LOCATION",
"city": "Fort Wayne",
"state": "IN",
"postal_code": "468044140",
"country_code": "US",
"telephone_number": "260-435-2856",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GIBSON",
"first_name": "JEREMY",
"middle_name": "BRENDON",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-19",
"last_updated": "2025-08-28",
"certification_date": "2025-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "IN",
"license": "02007660A",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "KY",
"license": "C3863",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "MN",
"license": "55625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; 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.