Active NPI
Justin John Gamble
- Counselor
- Chelsea, MA
National Provider Identifier
1164689444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 300 Broadway
Chelsea, MA 02150-2808 - Phone
- (617) 912-7996
- NPI assigned
- May 22, 2008
- Last updated
- May 22, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | Primary |
Addresses
Primary practice location
300 Broadway
Chelsea, MA 02150-2808
Mailing address
300 Broadway
Chelsea, MA 02150-2808
Phone (617) 912-7996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130926000703 | MA | Practitioner - Clinical Social Worker | 6507000874 | Practice locations: Winthrop, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
185 Grovers Ave
Winthrop, MA 02152-1047
Phone (857) 496-5881
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211414400000",
"number": "1164689444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 BROADWAY",
"city": "CHELSEA",
"state": "MA",
"postal_code": "021502808",
"telephone_number": "617-912-7996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 BROADWAY",
"city": "CHELSEA",
"state": "MA",
"postal_code": "021502808",
"telephone_number": "617-912-7996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMBLE",
"first_name": "JUSTIN",
"middle_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-22",
"last_updated": "2008-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chelsea, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.