Corey Lyle Gambrell

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

901606 Issued in MS

Practice address

415 S 28TH Ave
Hattiesburg, MS 39401-7246

Phone

(601) 261-3606

Fax

(601) 579-5383

NPI assigned

Dec 9, 2019

Sex

Male

Sole proprietor

No

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

Enrolled in MS

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifelinc Anesthesia PLLCGroup PAC ID 0941347447, 169 clinicians

Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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 and National Provider Directory roles.

• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment Care Compare group NPD
• Lifelinc Anesthesia, PLLC

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1801021464

  MS, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Hattiesburg Clinic, PA

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD

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

• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  Care Compare affiliation

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1720625841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-261-3606",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-261-3606",
            "fax_number": "601-579-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBRELL",
        "first_name": "COREY",
        "middle_name": "LYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-09",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "901606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Gallaspy Jr., ATC, LAT, MS
• Connor Gregory Galloway
• Monique D Galloway, CIDDT
• Richard J Galloway, MD
• Angela Ramone Gamble, FNP
• Jarrod Edward Gant, DHA,DNP, APRN, FNP-C
• Graham T Gardner, CRNA
• Icerica Gardner
• Garner Nichols Dental PLLC
• Morgan Brittany Garner, HAS

• Certified Registered Nurse Anesthetist in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Certified Registered Nurse Anesthetist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.