Active NPI
Fredrick Anthony Gardin, ATC, CSCS, USAW
- Athletic Trainer
- Columbia, SC
National Provider Identifier
1205933454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 788
- Practice address
- 500 Harbison Blvd
Apt 2310
Columbia, SC 29212-1735 - Phone
- (803) 673-6155
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 788 | SC | Primary |
Addresses
Primary practice location
500 Harbison Blvd
Apt 2310
Columbia, SC 29212-1735
Mailing address
500 Harbison Blvd
Apt 2310
Columbia, SC 29212-1735
Phone (803) 673-6155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 788 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205933454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 HARBISON BLVD",
"address_2": "APT 2310",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292121735",
"telephone_number": "803-673-6155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 HARBISON BLVD",
"address_2": "APT 2310",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292121735",
"telephone_number": "803-673-6155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDIN",
"first_name": "FREDRICK",
"middle_name": "ANTHONY",
"credential": "ATC, CSCS, USAW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SC",
"license": "788",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.