Gamble Hospice Care Northwest, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

2203781702 Issued in LA

Legal business name

GAMBLE HOSPICE CARE NORTHWEST, LLC

Practice address

8950 E Kings Hwy
Shreveport, LA 71115

Phone

(318) 861-2150

Fax

(318) 861-2157

NPI assigned

Jun 9, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Beal

Title

Chief Executive Officer

Phone

(214) 252-7600

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Aime Hospice Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vrunda Amol Takalkar, PT

  • Physical Therapist
  • Atlanta, GA
  • NPI 1124408356
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1225079643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N PEARL ST STE 1050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752017495",
            "telephone_number": "214-252-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 E KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71115",
            "telephone_number": "318-861-2150",
            "fax_number": "318-861-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAMBLE HOSPICE CARE NORTHWEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "214-252-7600"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "LA",
            "license": "2203781702",
            "primary": true
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "LA",
            "license": "150",
            "primary": false
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "LA",
            "license": "2203781702-I",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1581089",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aime Hospice Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patrick Timothy Gallagher Sr., M.D.
• Gallego Health
• William H Gallmann III, M.D.
• Jerome Keith Galloway
• Lynda J Galloway, LAC
• Rupal Gamble, PA-C
• Rajendra T Gandhi, MD
• Gale Gandy
• Latrishia Gant Jackson
• Gail Gant

• Community Based Hospice Care Agency in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Community Based Hospice Care Agency in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.