MR. BRAD GIBSON (APRN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1205449261

MR. BRAD GIBSON (APRN) is a healthcare provider. based in Mason, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. APRN.CNP.0029637 (OH). The NPI Number for MR. BRAD GIBSON (APRN) is 1205449261

Main info

Male
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
MR. BRAD GIBSON (APRN)
NPI
1205449261
Phone
(513) 204-1910
Address
3615 SOCIALVILLE FOSTER RD STE C
Enumeration Date
28 August 2020
Last Update Date
24 January 2024

Doctor Profile

Medical School Name
UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
2021 (5 years ago)
PAC ID
8628465374
Professional Enrollment ID
I20220427000701
Address ID
OH454583664Ce10552LXXX400
Telehealth
Yes

Contacts

Secure Messaging
brad@leesidewellness.com
Secure Messaging
brad@alrhealth.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:5State licenses:1Other namesUpdated within 12 months

14,984 NURSE PRACTITIONER in OH

Provider Addresses for MR. BRAD GIBSON (APRN)

  • 3615 SOCIALVILLE FOSTER RD STE C

    MASON, OH 450409054

    Phone: (513) 204-1910

    Type: Mailing

  • 6300 N MAIN ST

    DAYTON, OH 454153154

    Phone: (937) 275-1500

    Type: Mailing

  • 10552 SUCCESS LN STE L

    CENTERVILLE, OH 454583664

    Phone: (937) 280-5711

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 13 Open Payments records for all available years, with a total value of $632.

Total Amount is formed as General ($632) + Research ($0) + Ownership ($0) = $632.

Last reported payment date: 2024-12-04 • Largest payer in this snapshot: ABBVIE INC. ($327).

Total Amount

$632

General + Research + Ownership

Payments

13

Total payment records

General Amount

$632

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-04

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2022-04-27

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
I20220427000701INurse PractitionerOHTBD

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 45040)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for MR. BRAD GIBSON (APRN)?
MR. BRAD GIBSON (APRN) — NPI 1205449261 — is the standard way to identify this listing.
Does the file indicate MR. BRAD GIBSON (APRN) is practicing under active NPI?
Directory data currently reports MR. BRAD GIBSON (APRN) as active.
What healthcare role does MR. BRAD GIBSON (APRN) hold?
Scheduling teams often label MR. BRAD GIBSON (APRN) under Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What address line appears for MR. BRAD GIBSON (APRN)?
MR. BRAD GIBSON (APRN)'s geographic hint is Mason, Ohio in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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