Active NPI
Mary Ann Gimbel, PT, CHT
- Physical Therapist
- Tamaqua, PA
National Provider Identifier
1215924873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT003911L
- Practice address
- 219 Claremont Ave
Tamaqua, PA 18252-4431 - Phone
- (570) 668-1889
- Fax
- (570) 668-6115
- NPI assigned
- Sep 29, 2005
- 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 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT003911L | PA | Primary |
| Hand Physical Therapist | 2251H1200X | |||
| Orthopedic Physical Therapist | 2251X0800X | |||
| Ergonomics Physical Therapist | 2251E1200X | |||
| Geriatric Physical Therapist | 2251G0304X | |||
| Pediatric Physical Therapist | 2251P0200X | |||
| Sports Physical Therapist | 2251S0007X |
Addresses
Primary practice location
219 Claremont Ave
Tamaqua, PA 18252-4431
Mailing address
219 Claremont Ave
Tamaqua, PA 18252-4431
Phone (570) 668-1889
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11227707 | Other | CAQH | |
| 22957 | Other | KEYSTONE | |
| 64762000 | Other | INDEPENDENCE BLUE CROSS | |
| 5051573 | Other | AETNA PPO | |
| 202758 | Other | HEALTH ASSURANCE | |
| 01401402 | Other | CAPITAL BLUE CROSS | |
| 800156 | Other | FIRST PRIORITY | |
| 22957 | Other | HIGHMARK BLUE SHIELD | |
| 2106685 | Other | AETNA HMO |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT003911L | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184803200000",
"number": "1215924873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 CLAREMONT AVE",
"city": "TAMAQUA",
"state": "PA",
"postal_code": "182524431",
"telephone_number": "570-668-1889",
"fax_number": "570-668-6115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "219 CLAREMONT AVE",
"city": "TAMAQUA",
"state": "PA",
"postal_code": "182524431",
"telephone_number": "570-668-1889",
"fax_number": "570-668-6115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIMBEL",
"first_name": "MARY",
"middle_name": "ANN",
"credential": "PT, CHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-29",
"last_updated": "2007-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT003911L",
"primary": true
},
{
"code": "2251H1200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Hand",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251E1200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Ergonomics",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11227707",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE",
"identifier": "22957",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENCE BLUE CROSS",
"identifier": "64762000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "5051573",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ASSURANCE",
"identifier": "202758",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "01401402",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST PRIORITY",
"identifier": "800156",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "22957",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "2106685",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Tamaqua, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.