Gina Gambucci, MS, LAT, ATC, OTC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

6308 8TH Ave
Kenosha, WI 53143-5031

Phone

(262) 656-2011

NPI assigned

Mar 13, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1003357823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3229 OLD HICKORY PL",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530958315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031",
            "telephone_number": "262-656-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3229 Old Hickory Pl",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530958315",
            "country_code": "US",
            "telephone_number": "262-343-1262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMBUCCI",
        "first_name": "GINA",
        "credential": "MS, LAT, ATC, OTC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-13",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J Gallo, R.PH
• Rosemary Gallo
• Bailey Margaret Galvin, DPT, PT
• Yolanda Gamazon-Waddell
• Elizabeth G Gamboa-Reynolds, LCSW
• Ganesha Institute of Neurology and Psychiatry SC
• Kelsey Kristen Garcia, LPC-IT
• Courtney Renee Gardner, APSW
• Chloe Elizabeth Carol Garofalo
• Katherine Cottam Garrahy

• Athletic Trainer in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.