Vernon Trip A Gardner, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD15617 Issued in ME

Practice address

181 Corporate Dr
Bangor, ME 04401-4314

Phone

(207) 992-2636

Fax

(207) 992-2638

NPI assigned

Sep 13, 2006

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Mount Rogers Community Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wytheville, VA
  • NPI 1255365599
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1184729451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-945-5247",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 CORPORATE DR",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014314",
            "telephone_number": "207-992-2636",
            "fax_number": "207-992-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "VERNON TRIP",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "MD15617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "409660099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles H Gardner Jr., LADC
• Jill B Gardner, LCSW
• Karen L Gardner, LCSW
• Michelle A Gardner, FNP-BC
• Michelle W Gardner, M.D.
• Sadie Raquel Garita
• Heather E Garrold, CNM
• Gary Agency
• Richard Allan Gary
• Anne M Gaspar, FNP

• Psychiatry Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Psychiatry Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.