DR. TIMOTHY E GIBSON (NPI# 1336120062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336120062 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY E GIBSON |
| Credential | M.D. |
| Practice Address |
55 Lake Ave N Department of Pediatric Hospitalist Medicine Worcester MA 01655-0002 |
| Mailing Address |
Po Box 415348 Boston MA 02241-0001 |
| Practice Telephone | 5088563590 |
| Practice Fax Number | 5088567989 |
| Mailing Telephone | 8002258885 |
| Mailing Fax Number | 5083341977 |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2020-11-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 212163 | MA | Allopathic & Osteopathic Physicians |
| N | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
212163 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | MEDICARE | A3400004 | 01 |
| MA | 110005892A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619303559 | Timothy Gibson | Behavioral Analyst | 3940 Scott Robinson Blvd, North Las Vegas, NV 89032-7859 | 2013-09-24 |
| 1396889515 | Timothy Daniel Gibson | Dentist | 1713 E 10th St Ste A, Jeffersonville, IN 47130-7100 | 2007-02-19 |
| 1588222939 | Timothy Curtis Gibson Jr. | Dentist | 101 Manning Dr, Chapel Hill, NC 27514-4226 | 2019-05-31 |
| 1104232503 | Timothy Gibson | Case Manager/Care Coordinator | 311 Whittington Ave, Hot Springs, AR 71901-3407 | 2014-07-07 |
| 1518136126 | Timothy J Gibson | Nurse Anesthetist, Certified Registered | 701 6th St S, St Petersburg, FL 33701-4814 | 2008-02-27 |
| 1104882802 | Timothy Blaise Gibson | Family Medicine | 892 Prince Ave, Athens, GA 30606-2724 | 2006-04-22 |
| 1760464242 | Timothy W Gibson | Orthopaedic Surgery | 17742 Beach Blvd, Suite 245, Huntington Beach, CA 92647-6818 | 2005-11-18 |
| Street Address |
55 LAKE AVE N DEPARTMENT OF PEDIATRIC HOSPITALIST MEDICINE |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556587 | James E Liebmann | Internal Medicine | 55 Lake Ave N, Hematology/oncology, Worcester, MA 01655-0002 | 2005-05-23 |
| 1518568732 | Justin Bullard | Psychologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-11-04 |
| 1346849825 | Meghan Moore | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-26 |
| 1174122899 | Jessica Goncalves Ferreira | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-23 |
| 1235746686 | Desiree Mytych | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-29 |
| 1659986248 | Rebecca Lynn Harris | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-10 |
| 1639781487 | Gabriella Kathleen Holland | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-21 |
| 1730791898 | Kerry Anne Benedict | Speech-Language Pathologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1902418999 | Natasha R. Turner | Genetic Counselor, MS | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1144830712 | Abbey Corsini | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164547014 | John A Riordan | Pediatrics | 117 Coolidge Rd, Worcester, MA 01602-2750 | 2007-03-20 |
| 1811071012 | Sheila M Callahan Butler | Pediatrics | 372 Chandler Street, Worcester, MA 01602 | 2006-10-24 |
| 1467551879 | Christine S. Freemer | Pediatrics | 291 Lincoln St Ste 101, Worcester, MA 01605-3643 | 2006-09-22 |
| 1306941794 | Mariam Lari | Pediatrics | Umass Memorial Children's Med. Ctr., 55 Lake Avenue North, Worcester, MA 01655 | 2006-09-13 |
| 1518991306 | Julie E Meyers | Pediatrics | Umass Medical School, 100 Century Drive, Worcester, MA 01613 | 2006-07-10 |
| 1487601068 | Nicholas Peter Pacella | Pediatrics | 45 Oak Ave, Worcester, MA 01605-2730 | 2006-05-28 |
| 1922098664 | Timothy Wells Watkins | Pediatrics | 650 Lincoln St, Worcester, MA 01605-2060 | 2005-10-25 |
| 1053319905 | Chandler Pediatrics | Pediatrics | 421 Chandler St., Worcester, MA 01602 | 2005-07-13 |
| 1952305997 | Catherine Anne Riordan | Pediatrics | 421 Chandler St, Worcester, MA 01602-2915 | 2005-06-08 |
| 1164950945 | Kamaris M Merritt | Pediatrics | 119 Belmont St, Worcester, MA 01605-2903 | 2017-05-24 |
| Find all providers in WORCESTER | ||||
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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.