Individual provider Active NPI

Brenda S Gardner, MD

  • Family Medicine Physician
  • Corpus Christi, TX
National Provider Identifier
1003889619
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L1858 Issued in TX
Practice address
5283 Old Brownsville Rd
.
Corpus Christi, TX 78405-3908
Phone
(361) 806-5600
Fax
(361) 806-5601
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L1858 TX Primary

Addresses

Primary practice location

5283 Old Brownsville Rd
.
Corpus Christi, TX 78405-3908

Mailing address

4800 Memorial Dr BLDG 4
Waco, TX 76711-1329
Phone (254) 297-3000

Other identifiers 1

IdentifierTypeStateIssuer
148208502MedicaidTX

Other names 1

  • Dr. Brenda S Gardner-Cortes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130617000066 TX Order and Referring Only - Family PracticePractitioner - Family Practice 7416919204

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Belinda Gonzalez MD PA Family Medicine Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1003889619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 MEMORIAL DR BLDG 4",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767111329",
            "telephone_number": "254-297-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5283 OLD BROWNSVILLE RD",
            "address_2": ".",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784053908",
            "telephone_number": "361-806-5600",
            "fax_number": "361-806-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "BRENDA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L1858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148208502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "GARDNER-CORTES",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.