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Dr. Fred Lloyd Gibson , DC

Chiropractor β€’ Jacksonville, FL

Active NPI 1578077228 Individual Practitioner Male Practitioner
Practice location in NPPES

12627 San Jose Blvd Ste 305
Jacksonville, FL 322238639

Call 9046834376 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

12627 San Jose Blvd Ste 305

Jacksonville, FL 322238639

Telephone 9046834376
Organization at the Same NPPES Address or Phone
Summit Integrative Health, Llc Facility NPI 1295202984

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2017

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Gibson has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Compared with the same specialty in Jacksonville and Florida

250 active clinicians are listed under Chiropractor with a practice address in Jacksonville, FL (6,969 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Jacksonville

0% of these 250 clinicians have the CMS telehealth indicator.

26.4% of these 250 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-06-29
Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

License # reported to NPPES FL 12141

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - CHIROPRACTIC

Medicare Enrollment ID

I20230717003449

Enrollment State Jurisdiction

FL

PECOS Control ID

3173983574

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location September 26, 2023

Registered at 12627 SAN JOSE BLVD STE 305, JACKSONVILLE, FL 322238639 (Tel: 9046834376)

πŸ“
Updated Practice Location November 28, 2020

Registered at 483 N SEMORAN BLVD STE 104B, WINTER PARK, FL 327923800 (Tel: 4076307330)

βœ…
NPI Profile Active November 16, 2017

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) November 16, 2017

Registered at 1449 THOMASVILLE RD, TALLAHASSEE, FL 323035609 (Tel: 8507656038)

πŸ“
Business Mailing Address (Initial Record) November 16, 2017

Registered at 379 LAKE KATHRYN CIR, CASSELBERRY, FL 327073001 (Tel: 4079497037)

πŸ‘€
Provider Name / Credentials (Initial Record) November 16, 2017

Recorded as FRED GIBSON, DC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 16, 2017

Chiropractor (license number reported to NPPES: FL 12141)

🟒
Initial NPI Registration & Enumeration November 16, 2017

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1578077228
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 16, 2017
Last Update: September 26, 2023
Sole Proprietor: No

Other Chiropractors in Jacksonville

All Chiropractors in Jacksonville

Mailing Address

379 Lake Kathryn Cir

Casselberry, FL 327073001

Phone: 4079497037

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.