Individual provider Active NPI

Jill Christina Gardner, DC

  • Chiropractor
  • Westerville, OH
National Provider Identifier
1154475978
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3011 Issued in OH
Practice address
805 Hillsdowne Road
Westerville, OH 43081-3366
Phone
(614) 794-9900
Fax
(614) 794-9977
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3011 OH Primary

Addresses

Primary practice location

805 Hillsdowne Road
Westerville, OH 43081-3366

Mailing address

805 Hillsdowne Road
Westerville, OH 43081-3366
Phone (614) 794-9900

Other identifiers 2

IdentifierTypeStateIssuer
2331784MedicaidOH
202024529-00OtherOHBWC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041020000228 OH Practitioner - Chiropractic 4789645110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

805 Hillsdowne Rd
Suite B
Westerville, OH 43081-7309
Phone (614) 794-9900

805 Hillsdowne Rd B
Westerville, OH 43081-7309

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3011OHMDForensic Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunbury Chiropractic Center Inc Chiropractor PastSince Jan 1, 2000 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1154475978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 HILLSDOWNE ROAD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430813366",
            "telephone_number": "614-794-9900",
            "fax_number": "614-794-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 HILLSDOWNE ROAD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430813366",
            "telephone_number": "614-794-9900",
            "fax_number": "614-794-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JILL",
        "middle_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2331784",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "202024529-00",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.