Active NPI
Gayle G Wimberly, LPC
- Professional Counselor
- Flowood, MS
National Provider Identifier
1164616082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 893
- Practice address
- 582 Lakeland East Dr Ste C
Flowood, MS 39232-9025 - Phone
- (601) 898-7528
- Fax
- (601) 898-7577
- NPI assigned
- Sep 4, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 893 | MS | Primary |
Addresses
Primary practice location
582 Lakeland East Dr Ste C
Flowood, MS 39232-9025
Mailing address
582 Lakeland East Dr
Flowood, MS 39232-9025
Phone (601) 918-8414
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 29, 2025 through Jan 29, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 893 | MS | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709510400000",
"number": "1164616082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "582 LAKELAND EAST DR",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "392329025",
"telephone_number": "601-918-8414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "582 LAKELAND EAST DR STE C",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "392329025",
"telephone_number": "601-898-7528",
"fax_number": "601-898-7577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIMBERLY",
"first_name": "GAYLE",
"middle_name": "G",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-04",
"last_updated": "2024-03-04",
"certification_date": "2024-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MS",
"license": "893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flowood, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.