Individual provider Active NPI

Nancy Windham Gardner, FNP

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1285682096
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
094149 Issued in GA
Practice address
8351 Westport Rd
Jacksonville, FL 32244-5901
Phone
(904) 317-8811
Fax
(904) 317-4949
NPI assigned
May 4, 2006
Last updated
Mar 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 094149 GA Primary

Addresses

Primary practice location

8351 Westport Rd
Jacksonville, FL 32244-5901

Mailing address

8351 Westport Rd
Jacksonville, FL 32244-5901
Phone (904) 317-8811

Other identifiers 1

IdentifierTypeStateIssuer
00949825AMedicaidGA

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

LicenseStateTypeSpecialty
094149GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Associates at Argyle PA Past Accepting new patients
Pediatric Associates at Argyle PA PastSince Aug 27, 2023 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1285682096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8351 WESTPORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445901",
            "telephone_number": "904-317-8811",
            "fax_number": "904-317-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8351 WESTPORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445901",
            "telephone_number": "904-317-8811",
            "fax_number": "904-317-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "NANCY",
        "middle_name": "WINDHAM",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "094149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00949825A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.