Dr James Gardner Internal Medicine

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

0416479 Issued in KS

Legal business name

DR JAMES GARDNER INTERNAL MEDICINE

Practice address

1133 College Ave
Suite D200
Manhattan, KS 66502-2770

Phone

(785) 537-4940

Fax

(785) 537-0836

NPI assigned

Dec 20, 2014

Last updated

Dec 20, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James Dixon Gardner, M.D.NPI 1497718092

Title

Ceo

Phone

(785) 537-4940

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Gardner, MD

  • Internal Medicine Physician
  • Manhattan, KS
  • NPI 1497718092
  NPD (past) Authorized official

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

{
    "created_epoch": "1419033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419033600000",
    "number": "1013315209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 COLLEGE AVE",
            "address_2": "SUITE D200",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665022770",
            "telephone_number": "785-537-4940",
            "fax_number": "785-537-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 COLLEGE AVE",
            "address_2": "SUITE D200",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665022770",
            "telephone_number": "785-537-4940",
            "fax_number": "785-537-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JAMES GARDNER INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-20",
        "last_updated": "2014-12-20",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "DIXON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-537-4940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KS",
            "license": "0416479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLD TAX ID  FROM OLD PRACTICE ENDED 12/31/2014",
            "identifier": "480839957",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN NPI NUMBER",
            "identifier": "1497718092",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Manhattan, KS
• Providers in Manhattan, KS by specialty
• Primary Care Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2014; 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.