Active NPI
Cory Lane Gardner, D.C.
- Chiropractor
- Elkins, WV
National Provider Identifier
1124060082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 803
- Practice address
- 301 Orchard St
Elkins, WV 26241-3338 - Phone
- (304) 636-2411
- Fax
- (304) 636-2411
- NPI assigned
- Jun 12, 2006
- 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 | 803 | WV | Primary |
Addresses
Primary practice location
301 Orchard St
Elkins, WV 26241-3338
Mailing address
301 Orchard St
Elkins, WV 26241-3338
Phone (304) 636-2411
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11351236 | Other | WV | CIGNA |
| 3810000836 | Medicaid | WV | |
| P00209889 | Other | WV | RAILROAD MEDICARE |
| WV00803 | Other | WV | THE HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040628001688 | WV | Practitioner - Chiropractic | 1254317308 | Practice locations: Elkins, WV |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 803 | WV | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1124060082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 ORCHARD ST",
"city": "ELKINS",
"state": "WV",
"postal_code": "262413338",
"telephone_number": "304-636-2411",
"fax_number": "304-636-2411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 ORCHARD ST",
"city": "ELKINS",
"state": "WV",
"postal_code": "262413338",
"telephone_number": "304-636-2411",
"fax_number": "304-636-2411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "CORY",
"middle_name": "LANE",
"name_prefix": "Mr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WV",
"license": "803",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "11351236",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810000836",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00209889",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THE HEALTH PLAN",
"identifier": "WV00803",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elkins, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.