Timothy L. Gardner, DPM,PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

30924 Issued in KY

Legal business name

TIMOTHY L. GARDNER, DPM,PC

Doing business as

Middlesboro Foot & Ankle Clinic

Practice address

123 N 19TH St
Middlesboro, KY 40965-2865

Phone

(606) 248-2739

Fax

(606) 248-2730

NPI assigned

Aug 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Logan Gardner, DPM

Title

Podiatrist

Phone

(606) 248-2739

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Middlesboro Foot & Ankle Clinic Doing business as

Locations

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318809600000",
    "number": "1225220379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 PARKSIDE DR STE 202",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379341981",
            "telephone_number": "865-218-7474",
            "fax_number": "865-218-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N 19TH ST",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652865",
            "telephone_number": "606-248-2739",
            "fax_number": "606-248-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY L. GARDNER, DPM,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-13",
        "last_updated": "2011-10-17",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "LOGAN",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "606-248-2739",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "KY",
            "license": "30924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3351921",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80002017",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0191729",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000053556",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middlesboro Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Foot & Ankle Surgery Podiatrist in Middlesboro, KY
• Providers in Middlesboro, KY by specialty
• Foot & Ankle Surgery Podiatrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.