Individual provider Active NPI

Brittany Gamble, LPN

  • Licensed Practical Nurse
  • Lisbon, OH
National Provider Identifier
1164018339
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
160903.MEDS-IV Issued in OH
Practice address
136 S Market St
Lisbon, OH 44432-1232
Phone
(330) 708-3548
Fax
(330) 954-0880
NPI assigned
Dec 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X 160903.MEDS-IV OH Primary

Addresses

Primary practice location

136 S Market St
Lisbon, OH 44432-1232

Mailing address

508 N Jefferson St
Lisbon, OH 44432-1054
Phone (330) 708-3584

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

State licenses

LicenseStateTypeSpecialty
160903.MEDS-IVOHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
KKC Life Management Services Single Specialty CurrentSince Jan 31, 2021 Accepting new patients

Locations

136 S Market St
Lisbon, OH 44432
Phone (234) 736-8425

Organizations & group practices 1

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": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1164018339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 N JEFFERSON ST",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444321054",
            "telephone_number": "330-708-3584",
            "fax_number": "330-954-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S MARKET ST",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444321232",
            "telephone_number": "330-708-3548",
            "fax_number": "330-954-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "BRITTANY",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "160903.MEDS-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisbon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.