Susan Rebecca Gamble, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A123317 Issued in CA

Practice address

10 Woodland Rd
Saint Helena, CA 94574-9554

Phone

(707) 963-2002

Fax

(707) 963-2003

NPI assigned

Apr 28, 2008

Last updated

Jan 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: susan.gamble.1@30311.direct.athenahealth.com

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.

• Lake County Tribal Health Consortium Inc.

  • Federally Qualified Health Center (FQHC)
  • Lakeport, CA
  • NPI 1881697381
  Medicare reassignment NPD
• Lake County Tribal Health Southshore Clinic

  • Federally Qualified Health Center (FQHC)
  • Clearlake, CA
  • NPI 1063158038
  NPD
• Adventist Health California Medical Group, Inc.

  dba St. Helena Internal Medicine

  • Internal Medicine Physician
  • Saint Helena, CA
  • NPI 1437474269
  NPD (past)
• First City Hospitalists Group PLLC

  • Hospitalist Physician
  • St Augustine, FL
  • NPI 1003053695
  NPD (past)

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1790950079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WOODLAND RD",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749554",
            "telephone_number": "707-963-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WOODLAND RD",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749554",
            "telephone_number": "707-963-2002",
            "fax_number": "707-963-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "SUSAN",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 109612",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A123317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14E2G",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dillan Nicole Firestone
• Alicia Kay Florez, FNP-BC
• Sarah Leslie Forni, MA, IMF
• Jessica Lee Friend, APRN, NP-C
• Shawn Fronterhouse, PA-C
• Shawn Garrity
• Deborah Geary, MD
• Tami S Glenn, CRNA
• Swaminadhan Gnanashanmugam, M.D.
• Melissa Ann Gold, PH.D.

• Internal Medicine Physician in Saint Helena, CA
• Providers in Saint Helena, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.