Individual provider Active NPI

Loretta G Gambrell, PT

  • Pediatric Physical Therapist
  • Panama City, FL
National Provider Identifier
1003844663
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT7388 Issued in FL
Practice address
927 Grace Ave
Panama City, FL 32401-2521
Phone
(850) 769-5371
Fax
(850) 872-9558
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT7388 FL Primary

Addresses

Primary practice location

927 Grace Ave
Panama City, FL 32401-2521

Mailing address

927 Grace Ave
Panama City, FL 32401-2521
Phone (850) 769-5371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT7388FLMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Physical Therapy PastSince Jan 1, 1990 Accepting new patients
Compass Physical Therapy PastSince Jan 1, 1990 Accepting new patients
Compass Physical Therapy PastSince Jan 1, 1990 Accepting new patients
Compass Physical Therapy PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1003844663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 GRACE AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012521",
            "telephone_number": "850-769-5371",
            "fax_number": "850-872-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 GRACE AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012521",
            "telephone_number": "850-769-5371",
            "fax_number": "850-872-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBRELL",
        "first_name": "LORETTA",
        "middle_name": "G",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "FL",
            "license": "PT7388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.