Carly Rose Gambill, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-033938 Issued in AZ

Practice address

5605 W Eugie Ave Ste 212&215
Glendale, AZ 85304-1272

Phone

(480) 210-6445

NPI assigned

Dec 26, 2024

Last updated

Jan 20, 2025By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Bullhead City, AZ
  • NPI 1093681033
  NPD (past)
• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Glendale, AZ
  • NPI 1528535689
  NPD (past)

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

{
    "created_epoch": "1735171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1205644036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17180 W SWEETWATER AVE UNIT 1120",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853883405",
            "telephone_number": "707-533-6754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 W EUGIE AVE STE 212&215",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041272",
            "telephone_number": "480-210-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBILL",
        "first_name": "CARLY",
        "middle_name": "ROSE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-26",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-033938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelley Galeano, LCSW
• Yelena R Galibov, LAMFT
• Joseph Emmanuel Gallardo, NP, FNP-C
• Denise Angelica Gallego, PT
• Jamie Galvan, OTA/L
• Game Changer Physical Therapy LLC
• Elva Mary Gamino -Charette, D.C.
• Nathan Gammage
• Danielle Gandolfo, SLPA
• Krithiga Ganesh Babu, M.D.

• Physical Therapist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.