Active NPI
Michael Gardner, DPT
- Physical Therapist
- Oakwood, GA
National Provider Identifier
1275946105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT011469
- Practice address
- 4220 Mundy Mill PL
Suite 2B
Oakwood, GA 30566-2573 - Phone
- (678) 450-9933
- Fax
- (678) 450-9933
- NPI assigned
- Jun 9, 2014
- Last updated
- Jun 9, 2014
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT011469 | GA | Primary |
Addresses
Primary practice location
4220 Mundy Mill PL
Suite 2B
Oakwood, GA 30566-2573
Mailing address
2400 Wisteria Dr
Suite a
Snellville, GA 30078-2689
Phone (770) 982-0102
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT011469 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402272000000",
"number": "1275946105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 WISTERIA DR",
"address_2": "SUITE A",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "300782689",
"telephone_number": "770-982-0102",
"fax_number": "770-982-0130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4220 MUNDY MILL PL",
"address_2": "SUITE 2B",
"city": "OAKWOOD",
"state": "GA",
"postal_code": "305662573",
"telephone_number": "678-450-9933",
"fax_number": "678-450-9933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "MICHAEL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-09",
"last_updated": "2014-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT011469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakwood, GA
- Maria Espana, RBT
- Extended Care Center of Oakwood LLC (Oakwood Family Physicians)
- Eye Site of Oakwood P.C.
- Adeela Farisi, PT
- Foot & Ankle Clinic of Oakwood, Inc.
- Newton B. Garrett, OD
- Georgia CVS Pharmacy, L.L.C. (CVS Pharmacy # 04721)
- Marti Renee Gibbs, MD
- Olivia Gavala Gooden
- GPF Solutions LLC-Gigi's Private Home Care
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.