Individual provider Active NPI

Thomas Whitney Gibson, D.O.

  • Pediatric Orthopaedic Surgery Physician
  • Greenville, SC
National Provider Identifier
1992867634
Registry record updated Mar 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
684 Issued in SC
Practice address
950 W Faris Rd
Greenville, SC 29605-4255
Phone
(864) 271-3444
Fax
(864) 255-7877
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Orthopaedic Surgery Physician 207XP3100X 053743 GA
Pediatric Orthopaedic Surgery Physician 207XP3100X 684 SC Primary
Pediatric Orthopaedic Surgery Physician 207XP3100X 9401197 NC

Addresses

Primary practice location

950 W Faris Rd
Greenville, SC 29605-4255

Mailing address

950 W Faris Rd
Greenville, SC 29605-4255
Phone (864) 271-3444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20140618001330 SC Practitioner - Orthopedic Surgery 6406908649 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
053743GAMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children Pediatric Orthopaedic Surgery CurrentSince Mar 22, 2014 Accepting new patients
Shriners Hospitals for Children CurrentSince Mar 22, 2014 Accepting new patients

Locations

950 W Faris Rd
Greenville, SC 29605
Phone (864) 255-7951

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268697600000",
    "number": "1992867634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054255",
            "telephone_number": "864-271-3444",
            "fax_number": "864-255-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054255",
            "telephone_number": "864-271-3444",
            "fax_number": "864-255-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "THOMAS",
        "middle_name": "WHITNEY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2010-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "GA",
            "license": "053743",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "SC",
            "license": "684",
            "primary": true
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "NC",
            "license": "9401197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.