Individual provider Active NPI

Allen E Gamble, D.O.

  • Family Medicine Physician
  • Greer, SC
National Provider Identifier
1265493605
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
557 Issued in SC
Practice address
1900 S Highway 14 Ste B
Greer, SC 29650-4731
Phone
(864) 469-3456
Fax
(864) 282-8545
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 557 SC Primary
Psychiatry Physician 2084P0800X DO557 SC

Addresses

Primary practice location

1900 S Highway 14 Ste B
Greer, SC 29650-4731

Mailing address

1900 S Highway 14 Ste B
Greer, SC 29650-4731
Phone (864) 469-3456

Other identifiers 1

IdentifierTypeStateIssuer
5577MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110208000811 SC Practitioner - Family PracticePractitioner - Osteopathic Manipulative MedicinePractitioner - Psychiatry 2365622354 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
557SCMDFamily Medicine Physician
DO557SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allen E Gamble, DO, LLC Family Medicine CurrentSince May 17, 2020 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients
Palmetto Infusion Services LLC Past Accepting new patients

Locations

1900 S Highway 14
Ste B
Greer, SC 29650
Phone (864) 469-3456

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1265493605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 S HIGHWAY 14 STE B",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296504731",
            "telephone_number": "864-469-3456",
            "fax_number": "864-282-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S HIGHWAY 14 STE B",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296504731",
            "telephone_number": "864-469-3456",
            "fax_number": "864-282-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "ALLEN",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "557",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "DO557",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5577",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.