NPIMap

Individual provider Active NPI

Renah T Gibson, DO

  • Family Medicine Physician
  • Enid, OK
National Provider Identifier
1972947943
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5563 Issued in OK
Practice address
3517 W Owen K Garriott Rd Ste 4
Enid, OK 73703-4953
Phone
(580) 233-5553
Fax
(580) 233-5641
NPI assigned
Apr 22, 2013
Last updated
Feb 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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 5563 OK Primary

Addresses

Primary practice location

3517 W Owen K Garriott Rd Ste 4
Enid, OK 73703-4953

Mailing address

PO Box 3046
Malvern, PA 19355-0746
Phone (580) 233-5553

Other practice location 1

915 E Garriott Rd
Enid, OK 73701-6156
Phone (580) 977-1910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141103001454 OK Practitioner - Family PracticePractitioner - Emergency Medicine 0143463950 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3517 W Owen K Garriott Rd
4 Family Physician Associates
Enid, OK 73703-4952
Phone (580) 233-5553

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Physician Associates, LLC CurrentSince Mar 1, 2020 Accepting new patients
St. Mary's Physician Associates, LLC Family Medicine CurrentSince Mar 1, 2020 Accepting new patients
Integris Ambulatory Care Corporation Family Medicine CurrentSince Sep 13, 2014 Accepting new patients
Summit Medical Center Past Accepting new patients
Uhs of Oklahoma, LLC Past Accepting new patients

Locations

1805 W Owen K Garriott Rd
Enid, OK 73703
Phone (580) 233-9012

302 N Independence St
Ste 600
Enid, OK 73701
Phone (580) 242-1300

330 S 5th St
Ste 302
Enid, OK 73701
Phone (580) 234-3320

330 S 5th St
Ste 305
Enid, OK 73701
Phone (580) 242-1224

330 S 5th St
Ste 401
Enid, OK 73701
Phone (580) 233-9700

3517 W Owen K Garriott Rd
Ste 4
Enid, OK 73703
Phone (580) 233-5553

600 S Monroe St
Enid, OK 73701
Phone (580) 233-2300

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

5300 N Independence Ave
Ste 280
Oklahoma City, OK 73112
Phone (405) 552-0155

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

Hospital & facility affiliations 10

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": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1972947943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3046",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193550746",
            "telephone_number": "580-233-5553",
            "fax_number": "580-233-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3517 W OWEN K GARRIOTT RD STE 4",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737034953",
            "telephone_number": "580-233-5553",
            "fax_number": "580-233-5641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 E Garriott Rd",
            "address_purpose": "LOCATION",
            "city": "Enid",
            "state": "OK",
            "postal_code": "737016156",
            "country_code": "US",
            "telephone_number": "580-977-1910",
            "fax_number": "580-237-1925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "RENAH",
        "middle_name": "T",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "5563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.