BRIAN CORDELL JR. GIBBS (CRNA) – Certified Registered Nurse Anesthetist, NPI 1053282368

BRIAN CORDELL JR. GIBBS (CRNA) is a healthcare provider. based in Madisonville, Kentucky. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 2025033705 (MO). The NPI Number for BRIAN CORDELL JR. GIBBS (CRNA) is 1053282368

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
BRIAN CORDELL JR. GIBBS (CRNA)
NPI
1053282368
Phone
(785) 717-9504
Address
112 CARLISLE DR
Enumeration Date
17 September 2025
Last Update Date
17 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2708255100
Graduation Year
2025 (1 year ago)
PAC ID
7416448881
Group Practice PAC ID
9830509686
Professional Enrollment ID
I20251113001016
Address ID
KY424311644MA900XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:0State licenses:2Digital endpointsOther names

1,371 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in KY

Provider Addresses for BRIAN CORDELL JR. GIBBS (CRNA)

  • 112 CARLISLE DR

    MADISONVILLE, KY 424319172

    Phone: (785) 717-9504

    Type: Mailing

  • 900 HOSPITAL DR

    MADISONVILLE, KY 424311644

    Phone: (785) 717-9504

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-11-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251113001016ICertified Registered Nurse Anesthetist (Crna)KYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 42431)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9830509686View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)TN
Certified Registered Nurse Anesthetist (Crna)KY
Certified Registered Nurse Anesthetist (Crna)KY
Certified Registered Nurse Anesthetist (Crna)KY
Certified Registered Nurse Anesthetist (Crna)KY
Certified Registered Nurse Anesthetist (Crna)KY
Certified Registered Nurse Anesthetist (Crna)KY
Certified Registered Nurse Anesthetist (Crna)KY
Certified Registered Nurse Anesthetist (Crna)KY
Certified Registered Nurse Anesthetist (Crna)KY

Reviews

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Frequently asked questions

Can I use this page to confirm BRIAN CORDELL JR. GIBBS (CRNA)'s NPI?
Yes. BRIAN CORDELL JR. GIBBS (CRNA) is listed with NPI 1053282368 in the public NPI dataset.
Does the file indicate BRIAN CORDELL JR. GIBBS (CRNA) is practicing under active NPI?
Directory data currently reports BRIAN CORDELL JR. GIBBS (CRNA) as active.
What taxonomy line describes BRIAN CORDELL JR. GIBBS (CRNA)?
For research purposes, treat BRIAN CORDELL JR. GIBBS (CRNA) as Certified Registered Nurse Anesthetist in this dataset. Clinical services aligned with this taxonomy classification.
Does BRIAN CORDELL JR. GIBBS (CRNA) list a practice location?
Patients near Madisonville, Kentucky may find BRIAN CORDELL JR. GIBBS (CRNA) in results; validate coverage separately.
Why does BRIAN CORDELL JR. GIBBS (CRNA) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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