Elizabeth Anne Gambill, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

2023009845 Issued in MO

Practice address

11133 Dunn Rd
Dept Anesthesiology
Saint Louis, MO 63136-6163

Phone

(800) 862-9980

Fax

(314) 362-1185

NPI assigned

Jul 9, 2021

Last updated

Jun 21, 2023By the provider in NPPES

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Christian Hospital Physician Billing Services LLC

  • Cardiovascular Disease Physician
  • Saint Louis, MO
  • NPI 1689828501
  Medicare reassignment NPD
• SSM Medical Group Inc.

  dba SSM Health Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Warrenton, MO
  • NPI 1467997155
  NPD
• SSM Medical Group, Inc.

  dba SSM Health Medical Group

  • Multi-Specialty Clinic/Center
  • Fenton, MO
  • NPI 1700966207
  NPD
• SSM Health Care St. Louis

  dba SSM Health St. Joseph Hospital - St. Charles Physician Billing

  • Emergency Medicine Physician
  • Saint Charles, MO
  • NPI 1427002922
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SSM Health Care St. Louis

  dba SSM Health St Joseph Hospital - Lake Saint Louis

  • General Acute Care Hospital
  • Lake St Louis, MO
  • NPI 1871665380
  Care Compare affiliation

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1174194104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8054",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD",
            "address_2": "DEPT ANESTHESIOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366163",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBILL",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-09",
        "last_updated": "2023-06-21",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2023009845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420122260",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "11133 Dunn Rd",
            "address_2": "Dept Anesthesiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631366163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kathy A Galvez, ANP
• Emily Galvin
• Kathryn Lavinia Galvin, LCSW
• Timothy D Galvin, MSW
• Mary Carolyn Gamache, M.D.
• Gary L Gambill, MD
• Justine Emily Gamblin
• Claudia Obimaa Gambrah-Lyles, MD
• Gamma Healthcare, Inc
• Julie K Gammack, MD

• Acute Care Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Acute Care Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.

Verify at the official NPI Registry.