Trevor Ryne Gobble, RESIDENT COUNSELOR

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0704016057 Issued in VA

Practice address

1120 By Pass Rd
Vinton, VA 24179-1835

Phone

(540) 767-2667

Fax

(540) 767-2669

NPI assigned

Jul 17, 2023

Last updated

Jul 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myspectrum, LLCGroup PAC ID 5799027843, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Myspectrum LLC

  • Mental Health Counselor
  • North Chesterfield, VA
  • NPI 1174029359
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1649959644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 BY PASS RD",
            "city": "VINTON",
            "state": "VA",
            "postal_code": "241791835",
            "telephone_number": "540-767-2667",
            "fax_number": "540-767-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 BY PASS RD",
            "city": "VINTON",
            "state": "VA",
            "postal_code": "241791835",
            "telephone_number": "540-767-2667",
            "fax_number": "540-767-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBBLE",
        "first_name": "TREVOR",
        "middle_name": "RYNE",
        "name_prefix": "Mr.",
        "credential": "RESIDENT COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0704016057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayne Lee Fitzgerald, PT
• Karen Renee Fuller, NURSE PRACTITIONER
• George Kevorkian Jr DDS PC
• Elizabeth S. Gillmore, PHD
• Justin Blake Gillum, PHARMD
• Morgan J Grant, PHARMD
• John Marshall Green III, DDS FACS
• R. Kevin Greenway, D.D.S.
• Tracy Grimes Shumate, OT
• Maruf Haider, M.D.

• Professional Counselor in Vinton, VA
• Providers in Vinton, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.