Individual provider Active NPI

Mary C Gamble, M.A., CCC-A

  • Audiologist
  • Plano, TX
National Provider Identifier
1124299367
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
51357 Issued in TX
Practice address
6300 W Parker Rd Ste 326
Plano, TX 75093-8104
Phone
(972) 378-0633
NPI assigned
Mar 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 51357 TX Primary

Addresses

Primary practice location

6300 W Parker Rd Ste 326
Plano, TX 75093-8104

Mailing address

6300 W Parker Rd Ste 326
Plano, TX 75093-8104
Phone (972) 378-0633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090428000194 TX Practitioner - Qualified Audiologist 6901954197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Otolaryngology Specialists of North Texas PAGroup PAC ID 4981830627, 6 clinicians

Practice addresses (Care Compare)

6300 W Parker Rd
Suite G24
Plano, TX 75093-8104

6300 W Parker Rd
Suite G24
Plano, TX 75093-8105
Phone (972) 378-0633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
51357TXMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Otolaryngology Specialists of North Texas PA CurrentSince Sep 7, 2013 Accepting new patients
Southwest ENT Associates PA PastSince Mar 23, 2009 Accepting new patients
Southwest ENT Associates PA Past Accepting new patients

Locations

6300 W Parker Rd
Ste 326
Plano, TX 75093
Phone (972) 378-0633

6300 W Parker Rd
Ste G24
Plano, TX 75093
Phone (972) 378-0633

Interoperability endpoints

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

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": "1205625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1124299367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 W PARKER RD STE 326",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938104",
            "telephone_number": "972-378-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 W PARKER RD STE 326",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938104",
            "telephone_number": "972-378-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "M.A., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-16",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "51357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.