Individual provider Active NPI

Camelia Gembala, FNP-C

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1104004191
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN122410 Issued in AZ
Practice address
3939 S Park Ave
Suite 150
Tucson, AZ 85714-1635
Phone
(520) 745-5001
Fax
(520) 573-9607
NPI assigned
Feb 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN122410 AZ Primary

Addresses

Primary practice location

3939 S Park Ave
Suite 150
Tucson, AZ 85714-1635

Mailing address

1016 W University Ave
Ste 206
Flagstaff, AZ 86001-2996
Phone (928) 266-1530

Other identifiers 1

IdentifierTypeStateIssuer
304607MedicaidAZ

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN122410AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carondelet Medical Group Inc Past Accepting new patients
Coconino County Health Department Past Accepting new patients
Community Partners Integrated Healthcare Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EAIEBA/Endpoint/EAIEBA

Organizations & group practices 3

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": "1201824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1104004191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 W UNIVERSITY AVE",
            "address_2": "STE 206",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012996",
            "telephone_number": "928-266-1530",
            "fax_number": "928-266-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 S PARK AVE",
            "address_2": "SUITE 150",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857141635",
            "telephone_number": "520-745-5001",
            "fax_number": "520-573-9607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEMBALA",
        "first_name": "CAMELIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-01",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN122410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304607",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.