Active NPI
William Vaughn Gardner, MD
- Orthopaedic Surgery Physician
- Wasilla, AK
National Provider Identifier
1245274133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 2454
- Practice address
- 2561 Mountain Village Dr
Suite F
Wasilla, AK 99654 - Phone
- (907) 290-3760
- Fax
- (907) 631-0647
- NPI assigned
- Jun 15, 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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 2454 | AK | Primary |
Addresses
Primary practice location
2561 Mountain Village Dr
Suite F
Wasilla, AK 99654
Mailing address
2561 Mountain Village Dr
Suite F
Wasilla, AK 99654
Phone (907) 376-2411
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD2454 | Medicaid | AK | |
| 200012546 | Other | MDCR RAILROAD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2454 | AK | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746748800000",
"number": "1245274133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2561 MOUNTAIN VILLAGE DR",
"address_2": "SUITE F",
"city": "WASILLA",
"state": "AK",
"postal_code": "99654",
"telephone_number": "907-376-2411",
"fax_number": "907-631-0647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2561 MOUNTAIN VILLAGE DR",
"address_2": "SUITE F",
"city": "WASILLA",
"state": "AK",
"postal_code": "99654",
"telephone_number": "907-290-3760",
"fax_number": "907-631-0647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "WILLIAM",
"middle_name": "VAUGHN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2025-05-09",
"certification_date": "2025-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "AK",
"license": "2454",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MD2454",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDCR RAILROAD",
"identifier": "200012546",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.