Individual provider Active NPI

Georgia Gamble

  • Obstetrics & Gynecology Physician
  • Boaz, AL
National Provider Identifier
1497287544
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
43031 Issued in AL
Practice address
2505 US Highway 431 Ste B
Boaz, AL 35957-5908
Phone
(256) 840-3396
Fax
(256) 840-3394
NPI assigned
Mar 29, 2017
Last updated
Feb 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 43031 AL Primary

Addresses

Primary practice location

2505 US Highway 431 Ste B
Boaz, AL 35957-5908

Mailing address

2505 US Highway 431 Ste B
Boaz, AL 35957-5908
Phone (256) 840-3396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210921001130 AL Practitioner - Obstetrics/Gynecology 1355610890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Alabama School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marshall Medical Center SouthGroup PAC ID 1153483797, 8 clinicians

Practice addresses (Care Compare)

2505 US Hwy 431
Suite B
Boaz, AL 35957-5908
Phone (256) 840-3396

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43031ALMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Medical Center North Obstetrics & Gynecology Past Accepting new patients
HH Health System - Marshall LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: georgiagamble@mcobg.allscriptsdirect.net
  • FHIR API: https://fhir-usa.unify.chbase.com/org/marshso-0747d29f
  • FHIR API: https://fhir-usa.unify.chbase.com/org/marshso-ac1b915e

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1497287544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 US HIGHWAY 431 STE B",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359575908",
            "telephone_number": "256-840-3396",
            "fax_number": "256-840-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 US HIGHWAY 431 STE B",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359575908",
            "telephone_number": "256-840-3396",
            "fax_number": "256-840-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "GEORGIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "43031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boaz, AL

Sources for this page

Verify at the official NPI Registry.