Individual provider Active NPI

Kendra Vanice Gamble-Webb, M.D.

  • Obstetrics & Gynecology Physician
  • Loganville, GA
National Provider Identifier
1770517674
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
057621 Issued in GA
Practice address
3869 Highway 81
Loganville, GA 30052-3918
Phone
(770) 466-3622
Fax
(770) 466-3630
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 057621 GA Primary

Addresses

Primary practice location

3869 Highway 81
Loganville, GA 30052-3918

Mailing address

3869 Highway 81
Loganville, GA 30052-3918
Phone (770) 466-3622

Other names 1

  • Kendra Vanice Gamble Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060926000001 GA Practitioner - Obstetrics/Gynecology 2062417025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of South Carolina School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

1984 Peachtree Rd NW
Suite 300
Atlanta, GA 30309-5219
Phone (404) 367-3210

2151 W Spring St
Monroe, GA 30655-3202
Phone (770) 267-8461

3869 Hwy 81
Loganville, GA 30052-3918
Phone (678) 635-8650

Hospital & facility affiliations

  • Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192
  • Piedmont Walton Hospital Hospital, Monroe, GA, CCN 110046

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Providers LLC CurrentSince Apr 1, 2018 Accepting new patients
Piedmont Walton Hospital Inc Past Accepting new patients

Locations

1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210

3869 Highway 81
#B
Loganville, GA 30052
Phone (770) 266-6252

3869 Highway 81
Loganville, GA 30052
Phone (678) 635-8280

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1770517674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3869 HIGHWAY 81",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300523918",
            "telephone_number": "770-466-3622",
            "fax_number": "770-466-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3869 HIGHWAY 81",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300523918",
            "telephone_number": "770-466-3622",
            "fax_number": "770-466-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE-WEBB",
        "first_name": "KENDRA",
        "middle_name": "VANICE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "057621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "GAMBLE",
            "middle_name": "VANICE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Loganville, GA

Sources for this page

Verify at the official NPI Registry.