Individual provider Active NPI

Nicholas Scot Gumbel, ATC, PTA

  • Physical Therapy Assistant
  • Yoder, IN
National Provider Identifier
1609101237
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06002951A Issued in IN
Practice address
5103 Yoder Rd
Yoder, IN 46798-9525
Phone
(260) 515-3542
NPI assigned
Oct 15, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06002951A IN Primary

Addresses

Primary practice location

5103 Yoder Rd
Yoder, IN 46798-9525

Mailing address

5103 Yoder Rd
Yoder, IN 46798-9525
Phone (260) 515-3542

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

State licenses

LicenseStateTypeSpecialty
06002951AINMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255564800000",
    "number": "1609101237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5103 YODER RD",
            "city": "YODER",
            "state": "IN",
            "postal_code": "467989525",
            "telephone_number": "260-515-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5103 YODER RD",
            "city": "YODER",
            "state": "IN",
            "postal_code": "467989525",
            "telephone_number": "260-515-3542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMBEL",
        "first_name": "NICHOLAS",
        "middle_name": "SCOT",
        "credential": "ATC, PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-15",
        "last_updated": "2009-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06002951A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yoder, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; 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.