GIBSON RECOVERY OPTIMIZING WELLNESS – NPI #1093448011
Family Medicine

A family medicine physician who specializes in the diagnosis and treatment of addictions.

Health Care Provider Taxonomy Code for Family Medicine

GIBSON RECOVERY OPTIMIZING WELLNESS is a provider located in GIBSON CITY, IL. NPPES has assigned the NPI number 1093448011 to GIBSON RECOVERY OPTIMIZING WELLNESS on July 07, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “GIBSON RECOVERY OPTIMIZING WELLNESS” is a dba name, the actual legal business name for this organization is GIBSON COMMUNITY HOSPITAL ASSOCIATION. The primary taxonomy selected by this provider is 207QA0401X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Addiction Medicine

The NPI profile was previously updated about 4 years ago on Aug 02, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GIBSON RECOVERY OPTIMIZING WELLNESS below.

NPI Profile for
GIBSON COMMUNITY HOSPITAL ASSOCIATION

NPI Number
1093448011
Enumeration Date

(about 4 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GIBSON COMMUNITY HOSPITAL ASSOCIATION
Doing Business As (dba): GIBSON RECOVERY OPTIMIZING WELLNESS
Primary location
10 DOCTORS PARK
GIBSON CITY, IL 60936-2004
Phone: (217) 784-4251 Fax:
Mailing address
1120 N MELVIN ST
GIBSON CITY, IL 60936-1477
Phone: Fax:
Organization Subpart
Yes - GIBSON RECOVERY OPTIMIZING WELLNESS is subpart of another organization.
Authorized Official
MATTHEW ERTEL
CHIEF FINANCIAL OFFICER
Phone: (217) 784-2601
Updated
Certification Date
Aug 02, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QA0401X
- Family Medicine / Addiction Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.