Kevin K Gardner, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5055 Issued in MA

Practice address

28 New Driftway
Scituate, MA 02066-4532

Phone

(781) 545-8114

Fax

(781) 545-7390

NPI assigned

Oct 18, 2005

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Magill & Gardner Physical Therapy, PC

  • Physical Therapist
  • Scituate, MA
  • NPI 1508843806

  MA, Physical Therapist

  Medicare reassignment Care Compare group NPD

Specialty

Physical Therapist in Private Practice

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Magill and Gardner Physical Therapy PC 2 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 4, 2011.

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1245229798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "address_2": "28 NEW DRIFT WAY",
            "city": "SCITUATE",
            "state": "MA",
            "postal_code": "020660357",
            "telephone_number": "781-545-8114",
            "fax_number": "781-545-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 NEW DRIFTWAY",
            "city": "SCITUATE",
            "state": "MA",
            "postal_code": "020664532",
            "telephone_number": "781-545-8114",
            "fax_number": "781-545-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "KEVIN",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "5055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kristen Gotter, LICSW

• All providers in Scituate, MA
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.