Mary Ann Gardner, M.D.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

ME 102236 Issued in FL

Practice address

410 Celebration PL
Ste 300
Celebration, FL 34747-5433

Phone

(321) 939-3300

Fax

(321) 939-3303

NPI assigned

Nov 5, 2005

Last updated

Jan 5, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Jerry a Rubin MD

  dba Central Florida Hand Specialists

  • Orthopaedic Hand Surgery Physician
  • Orlando, FL
  • NPI 1932351178
  NPD (past)
• MWV Health Care Assoc

  dba MWV Pharmacy

  • Community/Retail Pharmacy
  • N. Conway, NH
  • NPI 1235131798
  NPD (past)

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

{
    "created_epoch": "1131148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1154312387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL",
            "address_2": "STE 300",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475433",
            "telephone_number": "321-939-3300",
            "fax_number": "321-939-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL",
            "address_2": "STE 300",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475433",
            "telephone_number": "321-939-3300",
            "fax_number": "321-939-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-05",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME 102236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE OF NH",
            "identifier": "8066149",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00160736",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINECARE",
            "identifier": "417360099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "01Y007499NH01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4583146",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30204589",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• FWC Urogynecology, LLC
• Jordan Leigh Galili, APRN
• Anthony Garcia, RBT
• Hugo Garcia, RPH
• Maidelyn Garcia
• Robyn M. Gardner, PA-C
• Yannelly Garrido Antigua, MD
• Lindsay Michelle Gates, M.D.
• Colleen Bernadette Gaughan, M.D.
• GBG Dental Solutions PLLC

• Sports Medicine (Orthopaedic Surgery) Physician in Celebration, FL
• Providers in Celebration, FL by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.