Charles E Gambla, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

00023999 Issued in AL

Practice address

4410 Watermelon Rd
Northport, AL 35473-5204

Phone

(205) 345-1520

Fax

(205) 345-1761

NPI assigned

Jun 8, 2006

Last updated

Sep 28, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

DermatologyAlso: Micrographic Dermatologic Surgery (MDS)

Education

Loyola University of Chicago, Stritch School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alabama Dermatology Associates, PCGroup PAC ID 4385633908, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.04 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

76.79

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cgambla@alabama.emadirect.md

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.

• Alabama Dermatology Associates, PC

  • Specialist
  • Northport, AL
  • NPI 1033128897
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1275573107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 WATERMELON RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735204",
            "telephone_number": "205-345-1520",
            "fax_number": "205-345-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 WATERMELON RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735204",
            "telephone_number": "205-345-1520",
            "fax_number": "205-345-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLA",
        "first_name": "CHARLES",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "00023999",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AL",
            "license": "00023999",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AL",
            "license": "00023999",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051504238",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051504238",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Foster
• Janice M Fountain, CRNA
• Four Winds/Four Seasons Assisted Living Homes,LLC
• Mechelle Louise Frazier, LPC
• Dana Elizabeth Free, CRNP
• Katherine Gambrell, DPT
• Gary R. Kilgo, M.D. , P.C. Kilgo Clinic
• Whitney Smith Gatlin, CRNP
• William A Gill, LCO
• Joslyn Tyese Gillespie, ED.S., LPC

• Dermatology Physician in Northport, AL
• Providers in Northport, AL by specialty
• Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; 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.