Individual provider Active NPI

Thomas J Gambrel, PHD, NCSP, LICENSED

  • School Psychologist
  • Phoenix, AZ
National Provider Identifier
1043824329
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
005240 Issued in AZ
Practice address
2702 E Flower St
Phoenix, AZ 85016-7498
Phone
(602) 381-6000
Fax
(602) 381-6019
NPI assigned
Sep 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 005240 AZ Primary

Addresses

Primary practice location

2702 E Flower St
Phoenix, AZ 85016-7498

Mailing address

821 E Desert Park LN
Phoenix, AZ 85020-4147
Phone (917) 886-2104

Other identifiers 1

IdentifierTypeStateIssuer
UNKNOWNMedicaidAZ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tgambrel@creightonschools.org Direct

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
005240AZMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Creighton School District PastSince Sep 6, 2020 Accepting new patients
County of Maricopa Creighton Elementary School PastSince Sep 6, 2020 Accepting new patients

Organizations & group practices 2

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": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1043824329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 E DESERT PARK LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204147",
            "telephone_number": "917-886-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 E FLOWER ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167498",
            "telephone_number": "602-381-6000",
            "fax_number": "602-381-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBREL",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD, NCSP, LICENSED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "AZ",
            "license": "005240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "UNKNOWN",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgambrel@creightonschools.org",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email Text",
            "address_1": "2702 E Flower St",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850167498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.