NPIMap

Individual provider Active NPI

Jeffrey Todd Gardner, MD

  • Family Medicine Physician
  • Clovis, CA
National Provider Identifier
1063588200
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A 64748 Issued in CA
Practice address
221 W Fir Ave #101
Clovis, CA 93611-0223
Phone
(559) 299-7294
Fax
(559) 299-0641
NPI assigned
Nov 28, 2006
Last updated
Mar 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 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 A 64748 CA Primary

Addresses

Primary practice location

221 W Fir Ave #101
Clovis, CA 93611-0223

Mailing address

PO Box 28949
Fresno, CA 93729-8949
Phone (559) 228-4200

Other names 1

  • Jeffrey Todd Gardner Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050607000850 CA Practitioner - Family Practice 2668415092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Diego School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

221 W Fir Ave
Suite 101
Clovis, CA 93611-0223
Phone (559) 299-7295

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions27
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group CurrentSince Jun 7, 2019 Accepting new patients
Community Foundation Medical Group Current Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients
Valley Children's Hospital Past Accepting new patients

Locations

221 W Fir Ave
Ste 101
Clovis, CA 93611
Phone (559) 297-1776

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

4770 W Herndon Ave
Fresno, CA 93722
Phone (559) 271-6300

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1063588200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28949",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937298949",
            "telephone_number": "559-228-4200",
            "fax_number": "559-224-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W FIR AVE #101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936110223",
            "telephone_number": "559-299-7294",
            "fax_number": "559-299-0641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JEFFREY",
        "middle_name": "TODD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A 64748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEFFREY",
            "last_name": "GARDNER",
            "middle_name": "TODD",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.