NPIMap

Individual provider Active NPI

Autumn Renee Gardner, APN

  • Family Nurse Practitioner
  • Sparks, NV
National Provider Identifier
1184945479
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN001207 Issued in NV
Practice address
3160 Vista Blvd
Sparks, NV 89436-6703
Phone
(775) 352-7200
Fax
(775) 352-7222
NPI assigned
Jun 21, 2010
Last updated
Jun 22, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN001207 NV Primary

Addresses

Primary practice location

3160 Vista Blvd
Sparks, NV 89436-6703

Mailing address

3160 Vista Blvd
Sparks, NV 89436-6703
Phone (775) 352-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101104001605 NV Practitioner - Nurse Practitioner 3274727003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Nevada School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joseph E Johnson MD and Assoc LTDGroup PAC ID 4981683976, 5 clinicians

Practice addresses (Care Compare)

3160 Vista Blvd
Sparks, NV 89436-6703
Phone 7753527200100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN001207NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph E Johnson MD & Assoc LTD CurrentSince Jul 26, 2010 Accepting new patients
Jay C. Chamberlain, M.D., Inc. PastSince Jul 26, 2010 Accepting new patients

Locations

3160 Vista Blvd
Sparks, NV 89436
Phone (775) 352-7200

Interoperability endpoints

  • Direct secure messaging: autumn.gardner@snfm.directbygreenway.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1184945479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 VISTA BLVD",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894366703",
            "telephone_number": "775-352-7200",
            "fax_number": "775-352-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 VISTA BLVD",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894366703",
            "telephone_number": "775-352-7200",
            "fax_number": "775-352-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "AUTUMN",
        "middle_name": "RENEE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APN001207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

Verify at the official NPI Registry.