Saralyn Gamble

Key facts

NPI

1508096637

Entity type

Individual (NPI type 1)

Primary specialty

Speech-Language Pathologist 235Z00000X

License

SLP003505 (GA)

Practice address

601 N Belair SQ Ste 19
Evans, GA 30809-4324

Phone

(706) 364-1486

Fax

(706) 364-1487

NPI assigned

Jul 23, 2009

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 23, 2009.

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248307200000",
    "number": "1508096637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N BELAIR SQ STE 19",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094324",
            "telephone_number": "706-364-1486",
            "fax_number": "706-364-1487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N BELAIR SQ STE 19",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094324",
            "telephone_number": "706-364-1486",
            "fax_number": "706-364-1487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "SARALYN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2009-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP003505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Evans, GA · Speech-Language Pathologist in Georgia