Marc Gamboa, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P21012 Issued in NC

Practice address

2350 Bentridge LN Apt 102
Fayetteville, NC 28304-0591

Phone

(910) 339-1731

NPI assigned

Feb 8, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Activcare Physical Therapy, LLC

  dba Pivot Physical Therapy of Carolina

  • Clinic/Center
  • Raleigh, NC
  • NPI 1548409626

  Physical Therapist

  Medicare reassignment NPD
• Cora North Carolina, LLC

  dba CORA Physical Therapy - Wilmington

  • Rehabilitation Clinic/Center
  • Wilmington, NC
  • NPI 1467964189
  NPD (past)

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1336893437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 S HORSEPEN RD",
            "city": "HARRELLS",
            "state": "NC",
            "postal_code": "284448867",
            "telephone_number": "910-366-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 BENTRIDGE LN APT 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283040591",
            "telephone_number": "910-339-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBOA",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda K Galvan, LCMHC, LPC
• Arryn Kasey Gamble, DPT
• Brian S Gamble, PHARMD
• Elizabeth Ann Gamble, PSY.D.
• Austin S Gamblin, MD
• Narendranath Reddy Ganampet
• James Michael Gannon, M.D.
• April Gant, MSN, FNP-BC
• Keri Gant
• Timothy Gant, LPC, LCAS, CSI

• Physical Therapist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.