Active NPI
Marlene Briones Gamallo, PT
- Physical Therapist
- Macon, GA
National Provider Identifier
1457590481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 003897
- Practice address
- 840 Pine St Ste 880
Macon, GA 31201-7525 - Phone
- (478) 743-7092
- NPI assigned
- Feb 15, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 003897 | GA | Primary |
Addresses
Primary practice location
840 Pine St Ste 880
Macon, GA 31201-7525
Mailing address
214 W Spring Dr
Macon, GA 31220-6644
Phone (478) 475-1015
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003897 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234656000000",
"number": "1457590481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 W SPRING DR",
"city": "MACON",
"state": "GA",
"postal_code": "312206644",
"telephone_number": "478-475-1015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 PINE ST STE 880",
"city": "MACON",
"state": "GA",
"postal_code": "312017525",
"telephone_number": "478-743-7092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMALLO",
"first_name": "MARLENE",
"middle_name": "BRIONES",
"name_prefix": "Miss",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-15",
"last_updated": "2009-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "003897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.