Active NPI
Devere Keen Gamble, M.T
- Massage Therapist
- Durango, CO
National Provider Identifier
1497198188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 3709
- Practice address
- 755 E 2ND Ave
Suite 2C
Durango, CO 81301-5498 - Phone
- (970) 946-1051
- NPI assigned
- Apr 11, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 3709 | CO | Primary |
Addresses
Primary practice location
755 E 2ND Ave
Suite 2C
Durango, CO 81301-5498
Mailing address
755 E 2ND Ave
Suite 2C
Durango, CO 81301-5498
Phone (970) 946-1051
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3709 | Other | CO | STATE LICENSE |
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
- Credentials
- Medical Technician
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365638400000",
"number": "1497198188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 E 2ND AVE",
"address_2": "SUITE 2C",
"city": "DURANGO",
"state": "CO",
"postal_code": "813015498",
"telephone_number": "970-946-1051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 E 2ND AVE",
"address_2": "SUITE 2C",
"city": "DURANGO",
"state": "CO",
"postal_code": "813015498",
"telephone_number": "970-946-1051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMBLE",
"first_name": "DEVERE",
"middle_name": "KEEN",
"credential": "M.T",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-11",
"last_updated": "2013-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "3709",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "3709",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durango, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.