NPIMap

Individual provider Active NPI

Collin Gamble

  • Diagnostic Radiology Physician
  • Louisville, KY
National Provider Identifier
1689102071
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
57828 Issued in KY
Practice address
One Audubon Plaza Drive
Louisville, KY 40217-1702
Phone
(502) 447-8786
Fax
(502) 447-8623
NPI assigned
May 30, 2017
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 57828 KY Primary

Addresses

Primary practice location

One Audubon Plaza Drive
Louisville, KY 40217-1702

Mailing address

9152 Taylorsville Rd # 276
Louisville, KY 40299-1702
Phone (502) 447-8786

Other practice location 1

9152 Taylorsville Rd # 276
Louisville, KY 40299-1702
Phone (502) 447-8786

Other identifiers 2

IdentifierTypeStateIssuer
7100893170MedicaidKY
300075464MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230515001956 KY Practitioner - Diagnostic Radiology 0244696409 Reassigns benefits to 1 organization
I20240327002609 IN Practitioner - Diagnostic Radiology 0244696409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Louisville School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic X-Ray Physicians, PSCGroup PAC ID 1355239534, 36 clinicians

Practice addresses (Care Compare)

1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone (502) 636-7111

1220 Missouri Ave
Jeffersonville, IN 47130-3725
Phone (502) 447-8786

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.52 of 100Reported as group
Quality
100
Improvement activities
40
Cost
91.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57828KYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic X-Ray Physicians, PSC Diagnostic Radiology CurrentSince May 8, 2023 Accepting new patients

Locations

2021 Mercy Way
Ste 102
Jeffersonville, IN 47130
Phone (812) 218-4630

1220 Missouri Ave
Jeffersonvlle, IN 47130
Phone (812) 282-2072

1451 N Gardner St
Scottsburg, IN 47170
Phone (812) 752-8500

130 Hunter Station Way
Sellersburg, IN 47172
Phone (812) 246-4808

157 Towne Dr
Ste 101
Elizabethtown, KY 42701
Phone (270) 740-5201

1 Audubon Plaza Dr
Louisville, KY 40217
Phone (502) 634-6767

3991 Dutchmans Ln
Ste 208
Louisville, KY 40207
Phone (502) 897-2440

850 S 28th St
Louisville, KY 40211
Phone (502) 629-7650

9152 Taylorsville Rd
Louisville, KY 40299
Phone (502) 424-5635

9344 Cedar Center Way
Louisville, KY 40291
Phone (502) 753-3390

Organizations & group practices 1

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.

Hospital & facility affiliations 41

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1689102071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9152 TAYLORSVILLE RD # 276",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402991702",
            "telephone_number": "502-447-8786",
            "fax_number": "502-447-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE AUDUBON PLAZA DRIVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171702",
            "telephone_number": "502-447-8786",
            "fax_number": "502-447-8623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9152 TAYLORSVILLE RD # 276",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402991702",
            "country_code": "US",
            "telephone_number": "502-447-8786",
            "fax_number": "502-447-8623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "COLLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-30",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "57828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100893170",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300075464",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.