Individual provider Active NPI

Dee T Gardner, D.O

  • Hospitalist Physician
  • Logan, UT
National Provider Identifier
1194184747
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
12998394-1204 Issued in UT
Practice address
1400 N 500 E
Logan, UT 84341-2455
Phone
(435) 716-1000
NPI assigned
Feb 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0102205263 VA
Hospitalist Physician 208M00000X 12998394-1204 UT Primary

Addresses

Primary practice location

1400 N 500 E
Logan, UT 84341-2455

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone (702) 653-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230503003272 UT Practitioner - Hospitalist 6709179328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1400 N 500
Logan, UT 84341-2455
Phone (435) 716-5307

Hospital & facility affiliations

  • Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015
  • Bear Lake Memorial Hospital Hospital, Montpelier, ID, CCN 131316
  • Logan Regional Hospital Transitional Care Unit Nursing home, Logan, UT, CCN 465123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102205263VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jun 18, 2023 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Jun 18, 2023 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1400 N 500 E
North Logan, UT 84341
Phone (435) 716-1000

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1194184747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N 500 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412455",
            "telephone_number": "435-716-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Las Vegas Blvd N",
            "address_purpose": "LOCATION",
            "city": "Nellis AFB",
            "state": "NV",
            "postal_code": "891916600",
            "country_code": "US",
            "telephone_number": "702-653-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "DEE",
        "middle_name": "T",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-10",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102205263",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "UT",
            "license": "12998394-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.