Individual provider Active NPI

Christopher M Gamble, O.D.

  • Corneal and Contact Management Optometrist
  • Bellefontaine, OH
National Provider Identifier
1356412886
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
4696 Issued in OH
Practice address
1008 N Main St
Bellefontaine, OH 43311-2371
Phone
(937) 599-5315
Fax
(937) 599-1185
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 4696 OH Primary

Addresses

Primary practice location

1008 N Main St
Bellefontaine, OH 43311-2371

Mailing address

1008 N Main St
Bellefontaine, OH 43311-2371
Phone (937) 599-5315

Other identifiers 3

IdentifierTypeStateIssuer
C9354411OtherOHMEDICARE PTAN
300285181027MedicaidOH
0215387MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050627001106 OH Practitioner - Optometry 5496790768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1008 N Main St
Bellefontaine, OH 43311-2371
Phone (937) 599-5315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4696OHMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
C and G Eyecare LLC Corneal and Contact Management CurrentSince Jan 1, 2005 Accepting new patients
North Main Eyecare, LLC CurrentSince Jan 2, 2016 Accepting new patients

Locations

1008 N Main St
Bellefontaine, OH 43311
Phone (937) 599-5315

Organizations & group practices 2

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505260800000",
    "number": "1356412886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112371",
            "telephone_number": "937-599-5315",
            "fax_number": "937-599-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112371",
            "telephone_number": "937-599-5315",
            "fax_number": "937-599-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2017-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OH",
            "license": "4696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "C9354411",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300285181027",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0215387",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefontaine, OH

Sources for this page

Verify at the official NPI Registry.