Individual provider Active NPI

Emily Marie Gardner

  • Student in an Organized Health Care Education/Training Program
  • Charlottesville, VA
National Provider Identifier
1225614076
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1215 Lee St.
Mail Stop '800904'
Charlottesville, VA 22908
Phone
(434) 982-1018
Fax
(434) 924-9492
NPI assigned
Mar 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1215 Lee St.
Mail Stop '800904'
Charlottesville, VA 22908

Mailing address

1215 Lee St.
Mail Stop '800904'
Charlottesville, VA 22908
Phone (434) 982-1018

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260617002577 NC Practitioner - Pathology 1153722475

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Wake Forest University School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

135 Crowne Chase Dr Apt
Suite 13
Winston Salem, NC 27104-3580

6100 Waterford District Dr
Suite 450
Miami, FL 33126-4692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1225614076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST.",
            "address_2": "MAIL STOP '800904'",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22908",
            "telephone_number": "434-982-1018",
            "fax_number": "434-924-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST.",
            "address_2": "MAIL STOP '800904'",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22908",
            "telephone_number": "434-982-1018",
            "fax_number": "434-924-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "EMILY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.