Individual provider Active NPI

Kathryn Michelle Gibson

  • Certified Registered Nurse Anesthetist
  • Jackson, MI
National Provider Identifier
1932783636
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704345108 Issued in MI
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 205-4946
NPI assigned
May 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704345108 MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806

Other practice location 1

5301 McAuley Dr
Ypsilanti, MI 48197-1051
Phone (734) 712-3456

Other practice location 2

7555 Grand River Rd
Brighton, MI 48114-9338
Phone (810) 854-8000

Other practice location 3

7575 Grand River Rd
Brighton, MI 48114-9309
Phone (810) 844-7575

Other practice location 4

12009 Maple Rd
Milan, MI 48160-9516
Phone (254) 718-3932

Other practice location 5

775 S Main St
Chelsea, MI 48118-1399
Phone (254) 718-3932

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230926001653 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719331669 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Michigan Medical School, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

205 N E Ave
Henry Ford Allegiance Health
Jackson, MI 49201-1753
Phone (517) 205-4800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc CurrentSince Sep 14, 2023 Accepting new patients
Wa Foote Memorial Hospital, Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 14, 2023 Accepting new patients

Locations

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

205 S East Ave
Jackson, MI 49201
Phone (517) 205-2103

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

Interoperability endpoints

  • Direct secure messaging: kgibson918920@direct.hfhs.org

Organizations & group practices 3

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 1

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": "1620432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1932783636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-4946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5301 McAuley Dr",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481971051",
            "country_code": "US",
            "telephone_number": "734-712-3456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7555 Grand River Rd",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481149338",
            "country_code": "US",
            "telephone_number": "810-854-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7575 Grand River Rd",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481149309",
            "country_code": "US",
            "telephone_number": "810-844-7575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12009 Maple Rd",
            "address_purpose": "LOCATION",
            "city": "Milan",
            "state": "MI",
            "postal_code": "481609516",
            "country_code": "US",
            "telephone_number": "254-718-3932",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "775 S Main St",
            "address_purpose": "LOCATION",
            "city": "Chelsea",
            "state": "MI",
            "postal_code": "481181399",
            "country_code": "US",
            "telephone_number": "254-718-3932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "KATHRYN",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-08",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704345108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.