Jimeyuki Gamble, MHPP – Case Manager/Care Coordinator

Key facts

NPI: 1770032039
Entity type: Individual (NPI type 1)
Primary specialty: Case Manager/Care Coordinator 171M00000X
Practice address: 304 N 6TH St
West Memphis, AR 72301-3221
Phone: (870) 732-1878
NPI assigned: Sep 28, 2016
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Case Manager/Care Coordinator	171M00000X			Yes

Addresses

Primary practice location

304 N 6TH St
West Memphis, AR 72301-3221

Mailing address

703 Calvin Avery Dr
Suite a
West Memphis, AR 72301-6501
Phone (870) 732-1878

Other names

Jimmy Gamble Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 28, 2016.

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1770032039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 CALVIN AVERY DR",
            "address_2": "SUITE A",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723016501",
            "telephone_number": "870-732-1878",
            "fax_number": "870-702-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N 6TH ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723013221",
            "telephone_number": "870-732-1878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "JIMEYUKI",
        "credential": "MHPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-28",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIMMY",
            "last_name": "GAMBLE",
            "credential": "MHPP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Memphis, AR

All providers in West Memphis, AR · Case Manager/Care Coordinator in Arkansas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.