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Dr. Keith D Gibson , PhD

Psychologist • Beloit, WI

Active NPI 1801014204 Individual Practitioner Male Practitioner
Practice location in NPPES

1969 W Hart Rd
Beloit, WI 535112230

Call 6083645686 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

1969 W Hart Rd

Beloit, WI 535112230

Telephone 6083645686
Fax 6083635756
Organization at the Same NPPES Address or Phone
Stateline Anesthesiologists Sc Facility NPI 1316937519

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

NPI first issued

2007

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, “Does 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

Compared with the same specialty in Beloit and Wisconsin

2 active clinicians are listed under Psychologist with a practice address in Beloit, WI (949 in Wisconsin).

Addresses are self-reported to NPPES and may be out of date.

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

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

License # reported to NPPES WI 522057

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

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: Wisconsin Department of Safety and Professional Services.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

4 listed
Dr. Maria Maria Anleu-Smith , MD

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1447367248

Doctor of Medicine (M.D.)

Dr. Yehia Khoga , MD

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1063400810

Doctor of Medicine (M.D.)

Cristina Kroeze

Counselor - Mental Health

NPI 1114315660
Dr. Howard Paul , MD

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1265429401

Doctor of Medicine (M.D.)

Career & Practice History

NPI enumerated April 23, 2007.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to August 2026.

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NPI Administrative Meta

NPI Number: 1801014204
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 23, 2007
Last Update: July 08, 2007
Sole Proprietor: Yes

Mailing Address

N2788 Walden Ln

Lake Geneva, WI 531473439

Phone: 2622486789

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.