Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Jennie Lynn Gibson, PA-C

Individual provider Physician Assistant · NPI 1639886708

Mrs. Jennie Lynn Gibson, PA-C is a Physician Assistant in South Bend, Indiana. Qualified in 2022, 4 years ago. Practices with Central Indiana Orthopedics LLC, a 146-clinician group, works from 4 locations, accepts Medicare assignment and offers telehealth. Licensed in Indiana and Michigan.

Years since qualifying
4
Licensed in
IN, MI
In the registry since
2022
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

53880 Carmichael Dr
South Bend, IN 46635-1567
Phone: (574) 247-9441
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 303 S Nappanee St Ste F, Elkhart, IN 46514-2066 — (574) 247-9441
  • 60160 Bodnar Blvd, Mishawaka, IN 46544-9338 — (574) 247-9441
  • 2349 Lake Ave Ste 201, Plymouth, IN 46563-7837 — (574) 247-9441

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10003788A (IN)
Physician Assistant Taxonomy 363A00000X · Licence 5601011393 (MI)

Record details

NPI number1639886708
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 28, 2022
Last updated in NPPESSeptember 3, 2024
Certification dateSeptember 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Central Indiana Orthopedics Llc — 146 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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