Individual provider Active NPI

Gretchen Kay Gardner, M.D.

  • Psychiatry Physician
  • Beachwood, OH
National Provider Identifier
1265653703
Registry record updated Sep 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35.066633 Issued in OH
Practice address
24200 Chagrin Blvd
Beachwood, OH 44122-5550
Phone
(216) 831-6466
Fax
(216) 766-6083
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35.066633 OH Primary

Addresses

Primary practice location

24200 Chagrin Blvd
Beachwood, OH 44122-5550

Mailing address

24200 Chagrin Blvd
Beachwood, OH 44122-5550
Phone (216) 831-6466

Other identifiers 1

IdentifierTypeStateIssuer
0149226MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20121107000171 OH Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 2860643533 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.066633OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Health Inc CurrentSince Mar 10, 2018 Accepting new patients
Signature Health, Inc. CurrentSince Mar 10, 2018 Accepting new patients

Locations

24200 Chagrin Blvd
Beachwood, OH 44122

24200 Chagrin Blvd
Ofc Pl
Beachwood, OH 44122
Phone (216) 283-7690

21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100

7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855

Interoperability endpoints

  • Direct secure messaging: ggardner327460@direct.ochin.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1265653703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24200 CHAGRIN BLVD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225550",
            "telephone_number": "216-831-6466",
            "fax_number": "216-766-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24200 CHAGRIN BLVD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225550",
            "telephone_number": "216-831-6466",
            "fax_number": "216-766-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "GRETCHEN",
        "middle_name": "KAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.066633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0149226",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.