Gary Roscoe Gardner, D.C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4707 Issued in KY

Practice address

13106 Shelbyville Rd
Louisville, KY 40243-1572

Phone

(502) 253-0025

Fax

(502) 253-9933

NPI assigned

Jul 31, 2006

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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Middletown Chiropractic

  • Chiropractor
  • Louisville, KY
  • NPI 1164613659
  NPD (past) Authorized official

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1083620041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5213 WINDY WILLOW DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402411360",
            "telephone_number": "502-241-6730",
            "fax_number": "502-253-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13106 SHELBYVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431572",
            "telephone_number": "502-253-0025",
            "fax_number": "502-253-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "GARY",
        "middle_name": "ROSCOE",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "000000347132",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50005767",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE NUMBER",
            "identifier": "650593",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "7135162",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "3428389",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariah Garcia, RBT
• Nicole Adriana Garcia
• Abigail B. Gardner, PA-C
• Bonnie B Gardner, APRN
• Emily Gardner, OTR
• Hugh K Gardner Jr., D.M.D.
• Jonathan Quinn Gardner, MD
• Leanne Lynne Gardner, M.A., LMFT
• Martha Louise Gardner, ARNP
• Meredith Rea Gardner, BCABA

• Chiropractor in Louisville, KY
• Providers in Louisville, KY by specialty
• Chiropractor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.