Individual provider Active NPI

Grant Alexander Gambrall, AUD

  • Audiologist-Hearing Aid Fitter
  • Grass Valley, CA
National Provider Identifier
1821561093
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
AU3258 Issued in CA
Practice address
457 Sutton Way
Grass Valley, CA 95945-4102
Phone
(530) 477-8114
Fax
(530) 477-1513
NPI assigned
Jan 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AU3258 CA
Audiologist-Hearing Aid Fitter 237600000X AU3258 CA Primary

Addresses

Primary practice location

457 Sutton Way
Grass Valley, CA 95945-4102

Mailing address

457 Sutton Way
Grass Valley, CA 95945-4102
Phone (530) 477-8114

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1821561093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 SUTTON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959454102",
            "telephone_number": "530-477-8114",
            "fax_number": "530-477-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 SUTTON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959454102",
            "telephone_number": "530-477-8114",
            "fax_number": "530-477-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBRALL",
        "first_name": "GRANT",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-09",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU3258",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "AU3258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.