Active NPI
Sandra Gardner
- Marriage & Family Therapist
- Macon, GA
National Provider Identifier
1083872121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 000959
- Practice address
- 116 Pierce Avenue
Macon, GA 31204 - Phone
- (478) 464-3025
- NPI assigned
- May 27, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 000959 | GA | Primary |
Addresses
Primary practice location
116 Pierce Avenue
Macon, GA 31204
Mailing address
304 Pierce Avenue
Macon, GA 31204
Phone (478) 464-3025
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000959 | GA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Methodist Home of the South Georgia Conference | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Macon, GA
- NPI 1497132914
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211846400000",
"number": "1083872121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 PIERCE AVENUE",
"city": "MACON",
"state": "GA",
"postal_code": "31204",
"telephone_number": "478-464-3025",
"fax_number": "478-742-3405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 PIERCE AVENUE",
"city": "MACON",
"state": "GA",
"postal_code": "31204",
"telephone_number": "478-464-3025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "SANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-27",
"last_updated": "2008-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "GA",
"license": "000959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.