Individual provider Active NPI

Pamela Dillard Gardner, C.S.C.A. C.C.S.

  • Addiction (Substance Use Disorder) Counselor
  • Asheville, NC
National Provider Identifier
1124135868
Registry record updated Jun 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1110 Issued in NC
Practice address
90 Asheland Ave
Asheville, NC 28801-4023
Phone
(828) 398-2251
Fax
(828) 254-1524
NPI assigned
Aug 25, 2006
Last updated
Jun 16, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1110 NC Primary

Addresses

Primary practice location

90 Asheland Ave
Asheville, NC 28801-4023

Mailing address

90 Asheland Ave
Asheville, NC 28801-4023
Phone (828) 398-2251

Other identifiers 2

IdentifierTypeStateIssuer
6110565MedicaidNC
145XHOtherNCBLUECROSS BLUESHIELD OF NORTH CAROLINA

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

LicenseStateTypeSpecialty
1110NCMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308182400000",
    "number": "1124135868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 ASHELAND AVE",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014023",
            "telephone_number": "828-398-2251",
            "fax_number": "828-254-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 ASHELAND AVE",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014023",
            "telephone_number": "828-398-2251",
            "fax_number": "828-254-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "PAMELA",
        "middle_name": "DILLARD",
        "name_prefix": "Mrs.",
        "credential": "C.S.C.A. C.C.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2011-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6110565",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF NORTH CAROLINA",
            "identifier": "145XH",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; 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.