Jered Steven Gambill, MSOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.009226 Issued in IL

Practice address

108 N 3Rd St
Mount Vernon, IL 62864-3624

Phone

(618) 244-1302

Fax

(618) 244-1302

NPI assigned

Apr 6, 2011

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1497044861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 E IL HIGHWAY 15",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628645072",
            "telephone_number": "618-241-7039",
            "fax_number": "618-241-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N 3RD ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628643624",
            "telephone_number": "618-244-1302",
            "fax_number": "618-244-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBILL",
        "first_name": "JERED",
        "middle_name": "STEVEN",
        "name_prefix": "Mr.",
        "credential": "MSOTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.009226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Anne Frost, FNP-C
• Kendra Kay Fry
• Janna Rachel Fulkerson, PT, DPT
• Anabella Gallia, MHP
• Amy Gamber, B.S.
• Nina Kristine Ganalon
• Brittney Garbo, MHP
• Kloe Garcia, LPN
• Gene R Gardner, CRNA
• Terri S Garrett, PT

• Occupational Therapist in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.