Andrea Dee Gardner, D.C.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

CH61001282 Issued in WA

Practice address

15215 SE 272ND St Ste 105
Kent, WA 98042-9918

Phone

(800) 404-6050

Fax

(866) 313-3397

NPI assigned

Nov 15, 2017

Last updated

Dec 30, 2022By the provider in NPPES

Sex

Female

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 3

Other names 1

• Andrea Dee Rake Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pro Sport and Spine PLLCGroup PAC ID 1658656384, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Pro Sport and Spine PLLC

  • Sports Physician Chiropractor
  • Gig Harbor, WA
  • NPI 1841672433

  Rehabilitation

  Medicare reassignment Care Compare group NPD
• Pro Sport Physical Therapy, LLC

  • Physical Therapist
  • Gig Harbor, WA
  • NPI 1114552155
  NPD (past)

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1194238857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 700688",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782700688",
            "telephone_number": "210-318-3007",
            "fax_number": "210-468-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15215 SE 272ND ST STE 105",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980429918",
            "telephone_number": "800-404-6050",
            "fax_number": "866-313-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "ANDREA",
        "middle_name": "DEE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-15",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WA",
            "license": "CH61001282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "CH12356",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "CH61001282",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "038.013678",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "records@airrosti-rehab-ctrs.direct.kno2fy.com",
            "affiliation": "Y",
            "affiliationName": "Airrosti Rehab Centers, LLC",
            "address_1": "111 Tower Dr Bldg 1",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782323625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "RAKE",
            "middle_name": "DEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elvie Vasquez Garcia, PROVIDER
• Lola Aneice Garcia
• Marianna Montes Garcia
• Melanie Garcia, D.D.S
• Zaidalid Garcia, LMP
• Lakenia Garnes
• D'Ajanayra Marie Garrett
• Matthew Garrison
• Meurn Gates
• Anastasia Gatuhi

• Rehabilitation Chiropractor in Kent, WA
• Providers in Kent, WA by specialty
• Rehabilitation Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.