Active NPI
Patricia Gamblin
- Physical Therapist
- West Melbourne, FL
National Provider Identifier
1700364676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT1569
- Practice address
- 2129 W New Haven Ave
West Melbourne, FL 32904-3875 - Phone
- (321) 676-8806
- NPI assigned
- Aug 2, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT1569 | FL | Primary |
Addresses
Primary practice location
2129 W New Haven Ave
West Melbourne, FL 32904-3875
Mailing address
245 Cahaba Valley Pkwy Ste 200
Pelham, AL 35124-2217
Phone (205) 942-6820
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT1569 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533168000000",
"number": "1700364676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 CAHABA VALLEY PKWY STE 200",
"city": "PELHAM",
"state": "AL",
"postal_code": "351242217",
"telephone_number": "205-942-6820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2129 W NEW HAVEN AVE",
"city": "WEST MELBOURNE",
"state": "FL",
"postal_code": "329043875",
"telephone_number": "321-676-8806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMBLIN",
"first_name": "PATRICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-02",
"last_updated": "2018-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT1569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.