Individual provider Active NPI

Keri Beth Gamberg, MS

  • Specialist
  • Ridgefield, CT
National Provider Identifier
1285996702
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
483219931 Issued in NY
Practice address
91 Bogus Rd
Ridgefield, CT 06877-1306
Phone
(203) 448-6428
NPI assigned
Jun 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 483219931 NY Primary

Addresses

Primary practice location

91 Bogus Rd
Ridgefield, CT 06877-1306

Mailing address

91 Bogus Rd
Ridgefield, CT 06877-1306
Phone (203) 448-6428

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
483219931NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1285996702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 BOGUS RD",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068771306",
            "telephone_number": "203-448-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 BOGUS RD",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068771306",
            "telephone_number": "203-448-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBERG",
        "first_name": "KERI",
        "middle_name": "BETH",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "483219931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.