Individual provider Active NPI

Stephen C. Gamblin, BCSI, LMT

  • Mechanotherapist
  • Bloomington, IN
National Provider Identifier
1659511012
Registry record updated Nov 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
Practice address
2112 S Montclair Ave
Bloomington, IN 47401-6814
Phone
(812) 330-0789
NPI assigned
Feb 25, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X
Massage Therapist 225700000X MT20902052 IN
Mechanotherapist 172M00000X Primary

Addresses

Primary practice location

2112 S Montclair Ave
Bloomington, IN 47401-6814

Mailing address

2112 S Montclair Ave
Bloomington, IN 47401-6814
Phone (812) 330-0789

Other identifiers 1

IdentifierTypeStateIssuer
MT20902052OtherININDIANA

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
MT20902052INMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764201600000",
    "number": "1659511012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 S MONTCLAIR AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474016814",
            "telephone_number": "812-330-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 S MONTCLAIR AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474016814",
            "telephone_number": "812-330-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLIN",
        "first_name": "STEPHEN",
        "middle_name": "C.",
        "credential": "BCSI, LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-25",
        "last_updated": "2025-11-27",
        "certification_date": "2025-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IN",
            "license": "MT20902052",
            "primary": false
        },
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA",
            "identifier": "MT20902052",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2025; 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.