Individual provider Active NPI

Leandra Gambee, GNP

  • Gerontology Nurse Practitioner
  • Cottage Grove, OR
National Provider Identifier
1356414478
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
200650166 Issued in OR
Practice address
1515 Village Dr
Cottage Grove, OR 97424-9700
Phone
(541) 942-6610
Fax
(541) 942-0353
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 200650166 OR Primary

Addresses

Primary practice location

1515 Village Dr
Cottage Grove, OR 97424-9700

Mailing address

PO Box 24410
Eugene, OR 97402-0451
Phone (541) 984-4301

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070425000502 OR Practitioner - Nurse Practitioner 2163424441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRM Physicians LLCGroup PAC ID 3678720729, 59 clinicians

Practice addresses (Care Compare)

6800 SW 105TH Ave
Beaverton, OR 97008-5468
Phone (503) 430-1777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
200650166ORMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CRM Physicians, LLC Gerontology CurrentSince Oct 1, 2023 Accepting new patients

Locations

6800 SW 105th Ave
Beaverton, OR 97008

6800 SW 105th Ave
Ste 206
Beaverton, OR 97008

650 SE Oak St
Hillsboro, OR 97123
Phone (503) 648-8588

Organizations & group practices 1

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1356414478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24410",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974020451",
            "telephone_number": "541-984-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 VILLAGE DR",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974249700",
            "telephone_number": "541-942-6610",
            "fax_number": "541-942-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBEE",
        "first_name": "LEANDRA",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "200650166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottage Grove, OR

Sources for this page

Verify at the official NPI Registry.