DR. ROBERT RANDALL GIBSON (NPI# 1700904406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700904406 |
| Entity Type | Individual |
| Full Name | DR. ROBERT RANDALL GIBSON |
| Credential | MD |
| Practice Address |
212 Carlanna Lake Rd Ste 100 Ketchikan AK 99901-5642 |
| Mailing Address |
Po Box 470 Kotzebue AK 99752-0470 |
| Practice Telephone | 9072288140 |
| Mailing Telephone | 9074427148 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2013-01-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 29061 | CO | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | A51581 | CA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 5493 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MD3965 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184968521 | Robert Lillie Gibson IIi | Pharmacist | 635 Beechwood Dr, Thomson, GA 30824-1869 | 2012-11-26 |
| 1174710024 | Robert Gibson | Chiropractor | 6128 Bandera Rd, San Antonio, TX 78238-1642 | 2007-09-25 |
| 1679777676 | Robert C Gibson | Nurse Practitioner | 3107 Milford Ter, Hamburg, NY 14075-2436 | 2007-06-13 |
| 1083788350 | Robert Lawrence Gibson | Dentist | 2303 N Coral Canyon Blvd #202, Washington, UT 84780 | 2006-11-20 |
| 1306947205 | Robert Bruce Gibson | Social Worker | 1500 E Woodrow Wilson Ave # 116a4, Jackson, MS 39216-5116 | 2006-09-26 |
| 1386749406 | Robert Douglas Gibson | Chiropractor | 12424 Big Timber Dr, Unit 4, Conifer, CO 80433-6410 | 2006-09-13 |
| 1366452922 | Robert G. Gibson | Pediatrics | 692 Ritchie Hwy # A, Severna Park, MD 21146-3919 | 2006-08-08 |
| 1336686476 | Robert Gibson | Counselor | 8200 E Jacque Dr, Prescott Valley, AZ 86314-6172 | 2017-01-27 |
| 1205232469 | Robert Gibson | Counselor | 507 E College St, Iowa City, IA 52240-5115 | 2014-11-14 |
| 1861806598 | Robert Gibson | Psychologist | 7921 Southpark Plz Ste 204, Littleton, CO 80120 | 2014-06-20 |
| Street Address |
212 CARLANNA LAKE RD STE 100 |
| City | KETCHIKAN |
| State | AK |
| Zip Code | 99901-5642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780676783 | Cheryl Ann Collier-brown | Internal Medicine | 212 Carlanna Lake Rd Ste 100, Ketchikan, AK 99901-5642 | 2005-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314215 | Residential Youth Care, Inc. | Community/Behavioral Health | 2442 Tongass Avenue, Ketchikan, AK 99901 | 2020-07-23 |
| 1316563026 | Residential Youth Care, Inc. | Community/Behavioral Health | 606 Hill Road, Ketchikan, AK 99901 | 2020-06-18 |
| 1043836851 | Residential Youth Care, Inc. | Community/Behavioral Health | 2514 1st Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1215553029 | Residential Youth Care, Inc. | Community/Behavioral Health | 2951 Baranof Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1174159222 | Helene Rae Simpson | Behavior Technician | 201 Deermont St, Ketchikan, AK 99901 | 2020-03-20 |
| 1003295155 | Suzanne Webb | Massage Therapist | 602 Dock St Ste 106, Ketchikan, AK 99901 | 2015-05-22 |
| 1093194342 | Kate Mortensen | Case Manager/Care Coordinator | 2690 Tongass Ave, Ketchikan, AK 99901 | 2015-05-20 |
| 1578879631 | Thomas Peter Ryan | Social Worker | 320 Bawden St. #318, Ketchikan, AK 99901 | 2010-08-27 |
| 1689820979 | Akeela Inc | Community Based Residential Treatment Facility, Mental Illness | 3050 Fifth Ave, Ketchikan, AK 99901 | 2008-08-18 |
| 1750565438 | Susan Marie Swift | Nurse Practitioner | 21 Jefferson Way, Suite 202, Psychiatry, Ketchikan, AK 99901 | 2007-12-18 |
| Find all providers in zip 99901 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871547869 | Jeanne Marie Snyder | Family Medicine | 1621 Tongass Ave, Suite 304, Ketchikan, AK 99901-6013 | 2006-05-22 |
| 1689634479 | Mark Edward Mitchell | Family Medicine | 2960 Tongass Avenue, Ketchikan, AK 99901-5742 | 2006-03-24 |
| 1154315109 | Kathryn Lynn Price | Family Medicine | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2005-09-06 |
| 1780036491 | Andrea A. Lui | Family Medicine | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2016-07-06 |
| 1710337381 | Ian Dobbe | Family Medicine | 3100 Tongass Ave, Ketchikan, AK 99901-5746 | 2016-06-15 |
| 1477847184 | Creekside Family Health Clinic Inc | Family Medicine | 320 Bawden St, Suite #313, Ketchikan, AK 99901-6573 | 2011-05-31 |
| 1538458138 | Andrew Briggs Sanders | Family Medicine | 212 Carlanna Lake Rd, Suite 100, Ketchikan, AK 99901-5642 | 2011-04-04 |
| 1407887763 | Diane L Liljegren | Family Medicine | 3100 Tongass Ave, Ketchikan, AK 99901-5746 | 2006-07-05 |
| 1003846197 | V Malurkar Anthes | Family Medicine | 3524 Tongass Ave, Ketchikan, AK 99901-5635 | 2006-07-04 |
| 1790711992 | Andrew D Pankow | Family Medicine | 3100 Tongass Ave, Ketchikan, AK 99901-5746 | 2006-06-23 |
| Find all providers in KETCHIKAN | ||||
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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.