Individual provider Active NPI

Caitlin Gardiner, M.D.

  • Psychiatry Physician
  • Jacksonville, FL
National Provider Identifier
1013449727
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME154485 Issued in FL
Practice address
1301 Riverplace Blvd Ste 800
Jacksonville, FL 32207-9032
Phone
(917) 634-5311
NPI assigned
Mar 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 308988 NY
Child & Adolescent Psychiatry Physician 2084P0804X ME154485 FL
Child & Adolescent Psychiatry Physician 2084P0804X 308988 NY
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X ME154485 FL Primary

Addresses

Primary practice location

1301 Riverplace Blvd Ste 800
Jacksonville, FL 32207-9032

Mailing address

109 W 27TH St Ste 5S
New York, NY 10001-6208
Phone (917) 634-5311

Other practice location 1

109 W 27th St Ste 5S
New York, NY 10001-6208
Phone (917) 634-5311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220726003350 FL Practitioner - Psychiatry 8325385966 Reassigns benefits to 1 organization

National Provider Directory

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

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": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1013449727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST STE 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "telephone_number": "917-634-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 RIVERPLACE BLVD STE 800",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079032",
            "telephone_number": "917-634-5311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 W 27th St Ste 5S",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100016208",
            "country_code": "US",
            "telephone_number": "917-634-5311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDINER",
        "first_name": "CAITLIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "308988",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME154485",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "308988",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME154485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.