DR. MARK S GIBSON (NPI# 1780737437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780737437 |
| Entity Type | Individual |
| Full Name | DR. MARK S GIBSON |
| Credential | MD |
| Practice Address |
3200 E Racine St Janesville WI 53546-2343 |
| Practice Telephone | 6083718000 |
| Mailing Telephone | 6083718000 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2015-04-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 23188 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32121000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922434380 | Mark S. Gibson | Specialist/Technologist, Other | 2104 Blind Pond Ave, Lutz, FL 33549-5580 | 2013-09-17 |
| 1215211008 | Mark J. Gibson | Social Worker | 3610 American River Dr Ste 140, Sacramento, CA 95864-5919 | 2011-09-28 |
| 1922324276 | Mark Duane Gibson | Military Health Care Provider | Uss Louisville, Fpo, AP 96671-2404 | 2010-04-12 |
| 1225115561 | Mark Tanner Gibson | Psychologist | 175 River View Dr, Green River, WY 82935-4811 | 2006-11-01 |
| 1437133444 | Mark C Gibson | Optometrist | 16306 E Lake Shore Dr, Austin, TX 78734-1132 | 2005-12-02 |
| 1720083439 | Mark William Gibson | Chiropractor | 7a Reich Street, Marsing, ID 83639-0252 | 2005-06-17 |
| 1619391802 | Mark Gibson | Orthotist | 3334 Capital Medical Blvd #400, Tallahassee, FL 32308-4470 | 2014-02-10 |
| 1417231465 | Mark W Gibson | Pharmacist | 1982 Eight Mile Rd, Cincinnati, OH 45255-2609 | 2011-10-07 |
| 1174845259 | Mark Anthony Gibson II | Physical Therapist | 1028 E Main St, Morehead, KY 40351-1328 | 2010-02-17 |
| 1710122106 | Mark Alan Gibson | Radiology | 545 Ne 47th Ave Ste 215, Portland, OR 97213-2237 | 2008-12-13 |
| Street Address |
3200 E RACINE ST |
| City | JANESVILLE |
| State | WI |
| Zip Code | 53546-2343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124026208 | Mark C. Torres | Obstetrics & Gynecology | 3200 E Racine St, Janesville, WI 53546-2343 | 2005-07-12 |
| 1033719703 | Macy G Bolt | Physical Therapist | 3200 E Racine St, Janesville, WI 53546-2343 | 2020-10-30 |
| 1407489016 | Joy P. Thompson | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2020-02-21 |
| 1851938419 | Hatsuho Wilkinson | Dietitian, Registered | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-12-03 |
| 1013563394 | Karrie R Lynch | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-13 |
| 1679128771 | Ellen Jean Ettlie | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-06 |
| 1881249126 | Elizabeth F Ramer | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-05 |
| 1093377905 | Nichole N Clark | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-07-01 |
| 1386202448 | Nicole M. Wentzien | Physical Therapist | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-06-04 |
| 1407322084 | Mark William Dantuma | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2018-10-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366911489 | Latoya Christina Anderson | Counselor | 1818 Pershing Pl, Janesville, WI 53546 | 2018-11-19 |
| 1922599216 | Megan Arney | Speech-Language Pathologist | 9680, 4445 Woodgate Dr., Janesville, WI 53546 | 2018-05-23 |
| 1770089955 | Abby Marie Harnack | Registered Nurse | 3901 Teal Ln, Janesville, WI 53546 | 2018-04-05 |
| 1962773648 | Clark Carroll | Nurse Practitioner | 1820 Center Ave, Janesville, WI 53546 | 2012-01-26 |
| 1689983793 | Fve Mw LLC | Assisted Living Facility | 3801 North Wright Road, Janesville, WI 53546 | 2010-10-07 |
| 1831354794 | County of Rock County Clerk | Community/Behavioral Health | 3506 Hwy 51, Janesville, WI 53546 | 2008-07-21 |
| 1528225422 | Walgreen Co | Pharmacy | 2519 Kettering St, Janesville, WI 53546 | 2008-05-19 |
| 1447420351 | Michele Renee Bohland | Physical Therapy Assistant | 2540 Humes Rd, Janesville, WI 53546 | 2008-03-06 |
| 1093992158 | Emma Gene Harrell | Counselor | 203 W Sunny Lane, Janesville, WI 53546 | 2008-01-30 |
| 1457473696 | Robert Louis Fleming | Dentist | 910 Conde St, Janesville, WI 53546 | 2007-04-06 |
| Find all providers in zip 53546 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902983034 | Matthew D Streckert | Emergency Medicine | 5000 Mineral Point Ave, Janesville, WI 53545 | 2006-11-01 |
| 1285601153 | William P West | Emergency Medicine | 4121 W Northwood Ct, Janesville, WI 53545-8335 | 2006-03-01 |
| 1538518386 | Jacob Ginglen | Emergency Medicine | 1000 Mineral Point Ave, Janesville, WI 53548-2940 | 2016-06-11 |
| 1548615982 | Tyler John Runde | Emergency Medicine | 1000 Mineral Point Ave, Janesville, WI 53548-2940 | 2016-05-03 |
| 1841652096 | Emily D. Wheelis | Emergency Medicine | 1000 Mineral Point Ave, Janesville, WI 53548-2940 | 2016-03-27 |
| 1104205467 | Christopher M. Koenig | Emergency Medicine | 1000 Mineral Point Ave, Janesville, WI 53548-2940 | 2015-05-20 |
| 1750768271 | Aaron Mark Taylor | Emergency Medicine | 1000 Mineral Point Ave, Janesville, WI 53548 | 2015-05-05 |
| 1316334683 | Jeffrey R. Nichols | Emergency Medicine | 1000 Mineral Point Ave, Janesville, WI 53548 | 2015-04-23 |
| 1508272139 | Ryan H Holzhauer | Emergency Medicine | 1000 Mineral Point Ave, Janesville, WI 53548 | 2014-07-03 |
| 1295172815 | Tracy M. Bishop | Emergency Medicine | 1000 Mineral Point Ave, Janesville, WI 53548-2940 | 2013-05-23 |
| Find all providers in JANESVILLE | ||||
| City | JANESVILLE |
| Zip Code | 53546 |
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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.