MR. MICHAEL CHARLES GIBBONS (NPI# 1659352441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659352441 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL CHARLES GIBBONS |
| Credential | P.T. |
| Practice Address |
2480 Liberty St Ne Salem OR 97303-6780 |
| Mailing Address |
File 50469 Los Angeles CA 90074-0469 |
| Practice Telephone | 5037633525 |
| Practice Fax Number | 5037633526 |
| Mailing Telephone | 5307780200 |
| Mailing Fax Number | 5307780200 |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2013-03-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
0979 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 227892 | 05 | |
| OR | MEDICARE DME NUMBER | 5467820001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801389788 | Michael Thomas Gibbons | Surgery | Surgery Clinic, 1801 Sunset Drive, Columbia, SC 29203 | 2018-06-14 |
| 1396153839 | Michael Gibbons | Skilled Nursing Facility | 93 Jordan Blvd, Delmar, NY 12054-4105 | 2014-07-29 |
| 1083895999 | Michael Joseph Gibbons | Registered Nurse | 12 Scenic Hills Dr, Ridge, NY 11961-3022 | 2007-11-19 |
| 1184693574 | Michael T Gibbons | Nurse Anesthetist, Certified Registered | 421 Se Osceola St, Ste 3, Stuart, FL 34994-2505 | 2006-03-16 |
| 1538167234 | Michael J Gibbons | Dentist | 7477 E Doubletree Ranch Rd, Suite 200, Scottsdale, AZ 85258-2048 | 2005-07-07 |
| 1063888253 | Michael Gibbons | Nurse Practitioner | 173 Chelsea St, Everett, MA 02149-4632 | 2015-08-11 |
| 1215126925 | Michael T Gibbons | Emergency Medicine | 1296 Tod Pl Nw, Suite 200, Warren, OH 44485-2474 | 2007-10-18 |
| 1285838763 | Michael D Gibbons | Hospitalist | 4220 Harding Rd, Suite 500, Nashville, TN 37205-2005 | 2007-06-11 |
| 1083825905 | Michael Gibbons | Massage Therapist | 19102 State Route 410 E Ste A, Bonney Lake, WA 98391-8449 | 2007-05-24 |
| 1659598563 | Michael Gibbons | Counselor | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2007-04-20 |
| Street Address |
2480 LIBERTY ST NE |
| City | SALEM |
| State | OR |
| Zip Code | 97303-6780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881694792 | Willamette Spine Center Ambulatory Surgery LLC | Clinic/Center | 2480 Liberty St Ne, Suite 120, Salem, OR 97303-6780 | 2005-07-21 |
| 1356726418 | Advanced Vascular Therapy LLC | Surgery | 2480 Liberty St Ne, Suite 110, Salem, OR 97301-8380 | 2015-07-29 |
| 1912308404 | Nash William Keene | Physician Assistant | 2480 Liberty St Ne, Suite 180, Salem, OR 97301-8380 | 2014-09-16 |
| 1326464181 | Janelle Zych | Physical Therapist | 2480 Liberty St Ne, Suite 140, Salem, OR 97301 | 2014-03-17 |
| 1336411636 | Donald Edwin Winder Jr. | Physician Assistant | 2480 Liberty St Ne, #110, Salem, OR 97301-8380 | 2012-02-01 |
| 1235466772 | Jessica Lauren Visintainer | Physical Therapist | 2480 Liberty St Ne, Ste 140, Salem, OR 97301-8380 | 2009-11-04 |
| 1023243474 | Pain Care Specialists, PC | Anesthesiology | 2480 Liberty St Ne, Suite 180, Salem, OR 97301-8380 | 2009-05-28 |
| 1982841565 | Priscilla Anne Walters | Social Worker | 2480 Liberty St Ne, Salem, OR 97301-8380 | 2009-01-19 |
| 1992999536 | Pacific Spine & Rehab, LLC | Clinic/Center | 2480 Liberty St Ne, Ste 180, Salem, OR 97301-8388 | 2007-08-28 |
| 1932310216 | Alyce M. Huntsinger | Nurse Practitioner | 2480 Liberty St Ne, Suite 180, Salem, OR 97301-8380 | 2007-05-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649750175 | Kristin Marie Barz | Behavioral Analyst | 4690 12th Ave Ne, Keizer, OR 97303 | 2018-08-15 |
| 1003359605 | Angela Rose Richard | Community Health Worker | 3410 Cherry Avenue Ne, Keizer, OR 97303 | 2016-11-30 |
| 1881146629 | Alma Denise Vera | Dental Hygienist | 5825 Shoreview Lane Ste C, Keizer, OR 97303 | 2016-10-27 |
| 1679919849 | Ramya Shyamala Kamath | Dentist | 4817 River Rd N, Keizer, OR 97303 | 2013-05-15 |
| 1356682041 | Teresa M Treinen | Physical Therapist | 190 Sandy Drive N, Keizer, OR 97303 | 2013-03-06 |
| 1598001844 | Eagle Eye Vision Care LLC | Optometrist | 4048 River Road North, Keizer, OR 97303 | 2012-12-13 |
| 1245590553 | Thora Jane Stacy | Dental Assistant | 2300 N.e. Lacncaster Dr., Salem, OR 97303 | 2012-05-21 |
| 1295028850 | Rodger Nordskog Magnuson | Pharmacist | 5452 River Road N., Keizer, OR 97303 | 2011-05-16 |
| 1326299843 | Douglas Scott Hamblin | Pediatrics | 5685 Inland Shores Way, Keizer, OR 97303 | 2008-10-02 |
| 1982870382 | Debra Kaye Lynch | Podiatrist | 4905 River Road N, Keizer, OR 97303 | 2008-05-06 |
| Find all providers in zip 97303 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033595129 | Derek Lee Palmer | Physical Therapist | 2521 Boone Rd Se # 100, Salem, OR 97306-9675 | 2015-07-31 |
| 1730564683 | Paula Pugh | Physical Therapist | 2975 River Rd S, Salem, OR 97302-9754 | 2015-07-21 |
| 1881017432 | Daniel Cordell Arnold | Physical Therapist | 6250 Commercial St Se, Salem, OR 97306-1333 | 2014-01-31 |
| 1194098517 | Jarrod Lummis | Physical Therapist | 1600 State St, Salem, OR 97301 | 2012-02-15 |
| 1538337977 | Christa K Antrim | Physical Therapist | 1600 State St, Salem, OR 97301-4257 | 2008-02-20 |
| 1477640225 | Chris C Jensen | Physical Therapist | 84 Highland Ave, Salem, MA 01970-2727 | 2006-10-05 |
| 1447231238 | Jennifer Lynn Hartford | Physical Therapist | 2480 Liberty St Ne, Salem, OR 97303-6780 | 2005-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170411 | Mind Body Therapy | Physical Therapist | 11959 Sw Garden Pl, Portland, OR 97223-8249 | 2020-09-24 |
| 1811512320 | Wesley Stoecker | Physical Therapist | 512 Main St., Suite 300, Monmouth, OR 97361 | 2020-06-10 |
| 1629638952 | Alana Vernon | Physical Therapist | 625 N Arrowleaf Trl Bldg G, Sisters, OR 97759-2610 | 2019-06-18 |
| 1992369532 | Mansi S Sabne | Physical Therapist | 2460 Nw Stewart Pkwy Ste 200, Roseburg, OR 97471-1501 | 2019-04-29 |
| 1447813084 | Prokaleo Physical Therapy, LLC | Physical Therapist | 12120 Sw Garden Pl, Tigard, OR 97223-8264 | 2019-04-18 |
| 1376010090 | Meredith Rae Brezinski | Physical Therapist | 18019 Sw Boones Ferry Road, Tigard, OR 97224 | 2018-10-31 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1578041976 | Sheridan Edward Pyeatt | Physical Therapist | 870 S Front St Ste 105, Central Point, OR 97502-2779 | 2018-07-30 |
| 1093204562 | Jessica Hund | Physical Therapist | 9385 Sw Greenburg Rd Ste 100, Portland, OR 97223-3200 | 2018-05-09 |
| 1659899151 | Mariel Hammond | Physical Therapist | 7522 N Lombard St, Portland, OR 97203-3235 | 2017-09-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.