{"npi":"1750624979","type":"NPI-1","status":"active","name":{"display":"Conrad Gibby M.D.","other":[],"first":"CONRAD","last":"GIBBY","middle":"CURTIS","credential":"M.D."},"specialty":{"primary_taxonomy":"2085R0204X","primary_taxonomy_description":"Vascular & Interventional Radiology Physician","slug":"vascular-interventional-radiology-physician","schema_org_specialty":null,"all":[{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"UT","license":"9724223-1205"},{"code":"2085R0204X","description":"Vascular & Interventional Radiology Physician","primary":false,"state":"AZ","license":"59934"},{"code":"2085R0204X","description":"Vascular & Interventional Radiology Physician","primary":false,"state":"CA","license":"A175297"},{"code":"2085R0204X","description":"Vascular & Interventional Radiology Physician","primary":true,"state":"UT","license":"9724223-1205"}]},"addresses":[{"purpose":"LOCATION","street_1":"3152 N UNIVERSITY AVE","city":"PROVO","state":"UT","postal_code":"846044745","country_code":"US","phone":"8012292002"},{"purpose":"MAILING","street_1":"3152 N UNIVERSITY AVE","city":"PROVO","state":"UT","postal_code":"846044745","country_code":"US","phone":"8012292002"}],"license":{"state":"UT","number":"9724223-1205"},"identifiers":[{"type_code":"01","label":"Other","value":"1750624979","state":"AZ","issuer":"BCBS OF AZ"},{"type_code":"05","label":"Medicaid","value":"1750624979","state":"AZ","issuer":null},{"type_code":"01","label":"Other","value":"Z237130","state":"AZ","issuer":"MEDICARE"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20190521001303","type_code":"14-94","type_desc":"PRACTITIONER - INTERVENTIONAL RADIOLOGY","state":"UT","pac_id":"3779832621"},{"enrlmt_id":"I20200207001627","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"AZ","pac_id":"3779832621"},{"enrlmt_id":"I20201030001894","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"NE","pac_id":"3779832621"}]},"enumeration_date":"2013-04-06","last_updated":"2022-07-15","_meta":{"source":"NPPES","snapshot_date":"2022-07-15","doc_url":"https://findmynpi.com/api"}}