Individual provider Active NPI

Traci Gamble

  • Hearing Instrument Specialist
  • Lady Lake, FL
National Provider Identifier
1568978930
Registry record updated Dec 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
Practice address
702 N US Highway 441
Lady Lake, FL 32159-3194
Phone
(352) 205-7361
NPI assigned
Dec 21, 2017
Last updated
Dec 21, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X Primary

Addresses

Primary practice location

702 N US Highway 441
Lady Lake, FL 32159-3194

Mailing address

702 N US Highway 441
Lady Lake, FL 32159-3194

Other identifiers 1

IdentifierTypeStateIssuer
AS3856OtherFLFLORIDA BOARD OF HEALTH

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

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1568978930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 N US HIGHWAY 441",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 N US HIGHWAY 441",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593194",
            "telephone_number": "352-205-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "TRACI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BOARD OF HEALTH",
            "identifier": "AS3856",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; 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.