Mary Kay Gamble, NURSE PRACTITIONER

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

184115 Issued in CO

Practice address

5755 Sorensen Pkwy
Omaha, NE 68152-2370

Phone

(402) 991-0330

NPI assigned

Jun 15, 2010

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)

Enrolled

State licenses

Practice roles

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.

• Shalom Park Professional Services LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Aurora, CO
  • NPI 1528232402
  NPD (past)

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1114248069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15814 CURTIS AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681164044",
            "telephone_number": "303-766-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 SORENSEN PKWY",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681522370",
            "telephone_number": "402-991-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "MARY KAY",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "184115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Marie Gamache, PTA
• Ishraga Gamal
• Destiny L Gamble
• Ebony K Gamble
• Makeasha Gamble
• Misti Gamble
• Nikole Gamble
• Rae'Van Gamble
• Skyler Gamble
• Lora Gamblin Page

• Gerontology Nurse Practitioner in Omaha, NE
• Providers in Omaha, NE by specialty
• Gerontology Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; 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.