Shasta Lee Gamble

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

Practice address

1300 Metro East Dr Ste 110
Pleasant Hill, IA 50327-8906

Phone

(515) 243-0011

Fax

(515) 243-7711

NPI assigned

Dec 17, 2018

Last updated

Dec 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Sass.Illy Endeavors, Inc.

  dba Comfort Keepers

  • Attendant Care Provider
  • Pleasant Hill, IA
  • NPI 1992321095
  NPD Authorized official

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1659843506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 METRO EAST DR STE 110",
            "city": "PLEASANT HILL",
            "state": "IA",
            "postal_code": "503278906",
            "telephone_number": "515-243-0011",
            "fax_number": "515-243-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 METRO EAST DR STE 110",
            "city": "PLEASANT HILL",
            "state": "IA",
            "postal_code": "503278906",
            "telephone_number": "515-243-0011",
            "fax_number": "515-243-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "SHASTA",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eye Care of Iowa PC
• Eyemart Express LLC
• Megan N Ferguson, ARNP
• Patrick Ford
• Angela Nicole Forsberg
• Henry W Garsayne
• Gonzalo Gaytan
• Brian Grace, BCBA
• GRX Holdings LLC
• Esgar Guarin, MD

• Attendant Care Provider in Pleasant Hill, IA
• Providers in Pleasant Hill, IA by specialty
• Attendant Care Provider in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; 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.