Individual provider Active NPI

Mark Allen Gibson, MD

  • Cardiovascular Disease Physician
  • Blairsville, GA
National Provider Identifier
1992744155
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
075625 Issued in GA
Practice address
191 Deep South Farm Rd
Blairsville, GA 30512-2220
Phone
(706) 439-6380
Fax
(706) 439-6398
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 075625 GA Primary

Addresses

Primary practice location

191 Deep South Farm Rd
Blairsville, GA 30512-2220

Mailing address

191 Deep South Farm Rd
Blairsville, GA 30512-2220
Phone (706) 439-6380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160628000411 GA Practitioner - Cardiovascular Disease (Cardiology) 5698772127 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of South Carolina School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

191 Deep S Farm Rd
Blairsville, GA 30512-2220
Phone (706) 439-6380

95 Collier NWRD
Atlanta, GA 30309-1796
Phone (404) 605-5000

95 Collier Rd NW
Suite 6000
Atlanta, GA 30309-1796
Phone (404) 605-2888

Hospital & facility affiliations

  • Union General Hospital Hospital, Blairsville, GA, CCN 110051
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Erlanger Murphy Medical Center Hospital, Murphy, NC, CCN 341328
  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • Piedmont Mountainside Hospital Inc Hospital, Jasper, GA, CCN 110225

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
075625GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union County Hospital Authority CurrentSince Feb 26, 2016 Accepting new patients
Piedmont Cardiology of Atlanta, LLC Cardiovascular Disease CurrentSince Apr 5, 2016 Accepting new patients
Union County Hospital Authority CurrentSince Feb 26, 2016 Accepting new patients
Wendy L Smith M.D. PC Past Accepting new patients
Heart Group PLLC Cardiovascular Disease Past Accepting new patients
Union County Hospital Authority Past Accepting new patients
Piedmont Professional Services, LLC Cardiovascular Disease Past Accepting new patients

Locations

275 Collier Rd NW
Ste 500
Atlanta, GA 30309
Phone (404) 355-6562

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

191 Deep South Farm Rd
Blairsville, GA 30512
Phone (706) 439-6380

35 Hospital Rd
Blairsville, GA 30512
Phone (706) 439-6812

19 Doctors Way
Ste C
Blairsville, GA 30512
Phone (706) 439-6380

15 Reinhardt College Pkwy
Ste 110A
Canton, GA 30114
Phone (770) 720-2383

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

220 J L White Dr
Ste 100
Jasper, GA 30143
Phone (706) 253-8001

Organizations & group practices 7

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 5

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1992744155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 DEEP SOUTH FARM RD",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305122220",
            "telephone_number": "706-439-6380",
            "fax_number": "706-439-6398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 DEEP SOUTH FARM RD",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305122220",
            "telephone_number": "706-439-6380",
            "fax_number": "706-439-6398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "075625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blairsville, GA

Sources for this page

Verify at the official NPI Registry.