Gary John Gardner, N.P.

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

209005922 Issued in IL

Practice address

4251 Forest Park Ave
Saint Louis, MO 63108-2810

Phone

(618) 363-9545

NPI assigned

Jul 13, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1003104993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 N PENNSYLVANIA AVE",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622203952",
            "telephone_number": "618-363-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 FOREST PARK AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082810",
            "telephone_number": "618-363-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "GARY",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-13",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209005922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean M Gardiner, PLPC
• Cooper Gardner, MD
• Danielle Gardner, AA
• Deborah Faye Gardner
• Erin Scott Gardner, M.D.
• Gina Lisette Gardner, NP
• Kari Gardner, NP
• Laura J Gardner, MD
• Marissa Gardner, DMD
• Morey Gardner, M.D.

• Women's Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Women's Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; 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.