GIBSON FAMILY PRACTICE – NPI #1316418288
Family Medicine

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

Health Care Provider Taxonomy Code for Family Medicine

GIBSON FAMILY PRACTICE is a provider located in SHREVEPORT, LA. NPPES has assigned the NPI number 1316418288 to GIBSON FAMILY PRACTICE on December 17, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “GIBSON FAMILY PRACTICE” is a dba name, the actual legal business name for this organization is DRG MEDICAL LLC. With multiple taxonomy codes selected, 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 6 years ago on Oct 26, 2020. 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 FAMILY PRACTICE below.

NPI Profile for
DRG MEDICAL LLC

NPI Number
1316418288
Enumeration Date

(more than 7 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
DRG MEDICAL LLC
Doing Business As (dba): GIBSON FAMILY PRACTICE
Primary location
1549 ELIZABETH AVE
SHREVEPORT, LA 71101-4501
Phone: (318) 918-0058 Fax:
1 Other location(s):
6319 W 70th St
Shreveport, LA 71129-2417
Phone: (318) 918-0058
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
WILLIAM GIBSON
MANAGER
Phone: (318) 918-0058
Updated
Certification Date
Oct 26, 2020

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.

Identifiers

Identifiers for GIBSON FAMILY PRACTICE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDLA1509639
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)
261QP2300X
- Clinic/Center / Primary Care

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.