Active NPI
Lance Gardner, D.C.
- Chiropractor
- Phoenix, AZ
National Provider Identifier
1083765325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 7330
- Practice address
- 6544 W Thomas Rd
Suite 37
Phoenix, AZ 85033-5738 - Phone
- (623) 849-1188
- NPI assigned
- Jan 15, 2007
- Last updated
- Aug 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 7330 | AZ | Primary |
Addresses
Primary practice location
6544 W Thomas Rd
Suite 37
Phoenix, AZ 85033-5738
Mailing address
6544 W Thomas Rd
Suite 37
Phoenix, AZ 85033-5738
Phone (623) 849-1188
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AZ0941900 | Other | AZ | BCBS ID NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7330 | AZ | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peterson Chiropractic Inc | Chiropractor | Past | Accepting new patients |
| Peterson Chiropractic | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187827200000",
"number": "1083765325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6544 W THOMAS RD",
"address_2": "SUITE 37",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850335738",
"telephone_number": "623-849-1188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6544 W THOMAS RD",
"address_2": "SUITE 37",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850335738",
"telephone_number": "623-849-1188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "LANCE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-15",
"last_updated": "2007-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "7330",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS ID NUMBER",
"identifier": "AZ0941900",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.