Peter Jeffrey Gembol, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

582495 Issued in TX

Practice address

2423 Williams Dr Ste 105
Georgetown, TX 78628-3200

Phone

(877) 800-5722

NPI assigned

Feb 4, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: peter.gembol.1@29821.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lone Star Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Georgetown, TX
  • NPI 1891746970
  Medicare reassignment NPD
• Lone Star Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1699289728
  NPD
• Lone Star Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Georgetown, TX
  • NPI 1639129331
  NPD (past)

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1679711279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR STE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283269",
            "telephone_number": "877-800-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR STE 105",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283200",
            "telephone_number": "877-800-5722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11111 Research Blvd",
            "address_2": "Ste 310",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787595264",
            "country_code": "US",
            "telephone_number": "877-800-5722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEMBOL",
        "first_name": "PETER",
        "middle_name": "JEFFREY",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-04",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "582495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "peter.gembol.p1@direct.lscctx.nextgenshare.com",
            "affiliation": "N",
            "address_1": "11111 Research Blvd",
            "address_2": "Ste 310",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787595264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Nurse Practitioner in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.