Active NPI
Daniel Jae Gardner
- Peer Specialist
- Arapahoe, WY
National Provider Identifier
1235005174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 199
- Practice address
- 24 Great Plains Loop
Arapahoe, WY 82510-8903 - Phone
- (307) 856-8090
- NPI assigned
- Oct 16, 2025
- Last updated
- Oct 16, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 199 | WY | Primary |
Addresses
Primary practice location
24 Great Plains Loop
Arapahoe, WY 82510-8903
Mailing address
PO Box 1062
Riverton, WY 82501-0119
Phone (307) 856-8090
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 |
|---|---|---|---|
| 199 | WY | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760572800000",
"number": "1235005174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1062",
"city": "RIVERTON",
"state": "WY",
"postal_code": "825010119",
"telephone_number": "307-856-8090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 GREAT PLAINS LOOP",
"city": "ARAPAHOE",
"state": "WY",
"postal_code": "825108903",
"telephone_number": "307-856-8090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "DANIEL",
"middle_name": "JAE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-10-16",
"last_updated": "2025-10-16",
"certification_date": "2025-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Peer Specialist",
"state": "WY",
"license": "199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arapahoe, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.