Individual provider Active NPI

Tina R Gamble, CMA

  • Community Health Worker
  • Adrian, MI
National Provider Identifier
1962103291
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
1040 S Winter St
Adrian, MI 49221-3876
Phone
(517) 263-8905
NPI assigned
Mar 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

1040 S Winter St
Adrian, MI 49221-3876

Mailing address

1040 S Winter St
Adrian, MI 49221-3876
Phone (517) 263-8905

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)
Not enrolled
Credentials
Certified Medical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1962103291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 S WINTER ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492213876",
            "telephone_number": "517-263-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 S WINTER ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492213876",
            "telephone_number": "517-263-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "TINA",
        "middle_name": "R",
        "credential": "CMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.