Individual provider Active NPI

Jan L Gardner, ARNP

  • Family Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1124065347
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 2735082 Issued in FL
Practice address
1350 S Hickory St
HRMC/Hospitalist Program
Melbourne, FL 32901-3224
Phone
(321) 434-1771
Fax
(321) 434-1775
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 2735082 FL Primary

Addresses

Primary practice location

1350 S Hickory St
HRMC/Hospitalist Program
Melbourne, FL 32901-3224

Mailing address

PO Box 561600
Rockledge, FL 32956-1600
Phone (321) 434-4600

Other identifiers 2

IdentifierTypeStateIssuer
Y0694HOtherFLBLUE CROSS
307595800MedicaidFL

Other names 1

  • Jan Laughton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060622000307 FL Practitioner - Nurse Practitioner 5092727669 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Hospitalists of Florida, LLCGroup PAC ID 6204130883, 12 clinicians

Practice addresses (Care Compare)

13695 US Hwy 1
Sebastian, FL 32958-3230
Phone (772) 589-3187

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 2735082FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Hospitalists of Florida, LLC CurrentSince Jun 11, 2016 Accepting new patients
Rockledge Physician Services, LLC CurrentSince Jul 1, 2018 Accepting new patients
Renaissance Medical Foundation Family CurrentSince Sep 4, 2022 Accepting new patients

Locations

110 Longwood Ave
Rockledge, FL 32955
Phone (321) 452-9799

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

5501 S McColl Rd
Edinburg, TX 78539
Phone (956) 362-3300

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337299200000",
    "number": "1124065347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 561600",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329561600",
            "telephone_number": "321-434-4600",
            "fax_number": "321-259-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S HICKORY ST",
            "address_2": "HRMC/HOSPITALIST PROGRAM",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013224",
            "telephone_number": "321-434-1771",
            "fax_number": "321-434-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JAN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2012-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 2735082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "Y0694H",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307595800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAN",
            "last_name": "LAUGHTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.