Maryann Cecelia Katherine Gamble, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DR.0075806 Issued in CO

Practice address

3107 Bonaventure CT
Pueblo, CO 81008-3100

Phone

(303) 338-4545

NPI assigned

Jun 11, 2008

Last updated

Sep 24, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Maryann Cecelia Dickson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, CO2 enrollments

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 2

Specialty

Family Practice

Education

University of Texas Medical School at San Antonio, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Colorado Permanente Medical Group, P.C.

  dba CPMG

  • Internal Medicine Physician
  • Denver, CO
  • NPI 1760599724
  Medicare reassignment Care Compare group NPD
• Austin Regional Clinic, PA

  • Family Medicine Physician
  • Austin, TX
  • NPI 1821157579
  Medicare reassignment NPD
• Austin Regional Clinic, PA

  dba ARC- Center Street

  • Durable Medical Equipment & Medical Supplies
  • Kyle, TX
  • NPI 1235746413
  NPD
• Seton Hospitalist Service

  dba Adult Inpatient Medical Services

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1013293679
  NPD (past)

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1295995439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 BONAVENTURE CT",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810083100",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3420 Fm 967 Ste B100",
            "address_purpose": "LOCATION",
            "city": "Buda",
            "state": "TX",
            "postal_code": "786103113",
            "country_code": "US",
            "telephone_number": "512-295-1333",
            "fax_number": "512-295-1335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "MARYANN",
        "middle_name": "CECELIA KATHERINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M9297",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0075806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201845902",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201845903",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3107 Bonaventure Ct",
            "city": "Pueblo",
            "state": "CO",
            "country_code": "US",
            "postal_code": "810083100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARYANN",
            "last_name": "DICKSON",
            "middle_name": "CECELIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sapphire Angel Gallegos
• Sarah Maria Gallegos, NP
• Tina Gallegos
• Venice Gallegos, M.A.
• Anne Galvin-Soto
• Ganapathy Bala MD LLC (Allergy and Asthma Center)
• Tim Joseph Gangel, MPT
• Lori Ann Ganni, MT.0020842
• Jacy Gansz-Torres, FNP
• Erin Amanda Gansz, LPC

• Family Medicine Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; 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.