Joan E Gibson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5548 Issued in SD

Practice address

1 Highway 18
Pine Ridge, SD 57770-9998

Phone

(605) 867-5131

Fax

(605) 867-3306

NPI assigned

Feb 3, 2006

Reactivated

Jan 18, 2008

Last updated

Mar 26, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Great Plains Tribal Chairmen's Health Board

  dba Oyate Health Center

  • Pharmacy
  • Rapid City, SD
  • NPI 1376105452

  TX

  Medicare reassignment NPD
• Regional Health Physicians Inc

  dba Hill City Regional Medical Clinic

  • Multi-Specialty Clinic/Center
  • Hill City, SD
  • NPI 1063458263
  NPD (past)
• Rosebud Indian Health Service

  • Ambulatory Surgical Clinic/Center
  • Rosebud, SD
  • NPI 1790955128
  NPD (past)

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1962474965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1201",
            "address_2": "HIGHWAY 18 EAST",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "577701201",
            "telephone_number": "605-867-5131",
            "fax_number": "605-867-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HIGHWAY 18",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "577709998",
            "telephone_number": "605-867-5131",
            "fax_number": "605-867-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JOAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2014-03-26",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SD",
            "license": "5548",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "33818",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "217566",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Marie Fernandez Burgos, PHARM.D
• Fort Meade Vamc
• Arrow Garnier, RN
• Vonda Lee Gates, RN
• James Brian Gibbon, RPH
• Elaine Gilfillan
• Nicole Joy Glines
• Paul Douglas Hall, RN
• Johanna Christine Hewitt, FNP
• Virginia Horn, REGISTERED NURSE

• Pediatrics Physician in Pine Ridge, SD
• Providers in Pine Ridge, SD by specialty
• Pediatrics Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.