Organization Active NPI

Gardner Medical Associates

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1174629604
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GARDNER MEDICAL ASSOCIATES
Practice address
333 Mt Pleasant Ave
Philadelphia, PA 19119
Phone
(215) 247-3300
Fax
(215) 247-0799
NPI assigned
Sep 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Shyrelle Gardner, MDNPI 1710948609
Title
Physician
Phone
(215) 247-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

333 Mt Pleasant Ave
Philadelphia, PA 19119

Mailing address

333 Mt Pleasant Ave
Philadelphia, PA 19119
Phone (215) 247-3300

National Provider Directory

National Provider Directory

Locations

333 W Mount Pleasant Ave
Philadelphia, PA 19119
Phone (215) 247-3300

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1174629604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 MT PLEASANT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19119",
            "telephone_number": "215-247-3300",
            "fax_number": "215-247-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 MT PLEASANT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19119",
            "telephone_number": "215-247-3300",
            "fax_number": "215-247-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDNER MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "SHYRELLE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "215-247-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.