Active NPI
Lorraine L Gardner, P.T.
- Physical Therapist
- Los Alamos, NM
National Provider Identifier
1306824164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 445
- Practice address
- 2101 Trinity Dr
Ste. N
Los Alamos, NM 87544-4102 - Phone
- (505) 661-6191
- Fax
- (505) 663-0386
- NPI assigned
- Jan 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 445 | NM | Primary |
| Ergonomics Physical Therapist | 2251E1200X | 445 | NM | |
| Hand Physical Therapist | 2251H1200X | 445 | NM | |
| Human Factors Physical Therapist | 2251H1300X | 445 | NM | |
| Neurology Physical Therapist | 2251N0400X | 445 | NM | |
| Pediatric Physical Therapist | 2251P0200X | 445 | NM | |
| Sports Physical Therapist | 2251S0007X | 445 | NM | |
| Orthopedic Physical Therapist | 2251X0800X | 445 | NM |
Addresses
Primary practice location
2101 Trinity Dr
Ste. N
Los Alamos, NM 87544-4102
Mailing address
2101 Trinity Dr
Ste. N
Los Alamos, NM 87544-4102
Phone (505) 661-6191
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 850448868 | Other | NM | ALL OTHER INSURANCIES |
| 201079804 | Other | NM | PRESBYTERIAN HEALTH PLAN |
| 00074136 | Medicaid | NM | |
| NM00Q036 | Other | NM | BLUECROSSBLUESHIELDS |
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 |
|---|---|---|---|
| 445 | NM | MD | Sports Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294012800000",
"number": "1306824164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 TRINITY DR",
"address_2": "STE. N",
"city": "LOS ALAMOS",
"state": "NM",
"postal_code": "875444102",
"telephone_number": "505-661-6191",
"fax_number": "505-663-0386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 TRINITY DR",
"address_2": "STE. N",
"city": "LOS ALAMOS",
"state": "NM",
"postal_code": "875444102",
"telephone_number": "505-661-6191",
"fax_number": "505-663-0386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "LORRAINE",
"middle_name": "L",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-03",
"last_updated": "2011-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "445",
"primary": true
},
{
"code": "2251E1200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Ergonomics",
"state": "NM",
"license": "445",
"primary": false
},
{
"code": "2251H1200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Hand",
"state": "NM",
"license": "445",
"primary": false
},
{
"code": "2251H1300X",
"taxonomy_group": "",
"desc": "Physical Therapist, Human Factors",
"state": "NM",
"license": "445",
"primary": false
},
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": "NM",
"license": "445",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NM",
"license": "445",
"primary": false
},
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "NM",
"license": "445",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NM",
"license": "445",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALL OTHER INSURANCIES",
"identifier": "850448868",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESBYTERIAN HEALTH PLAN",
"identifier": "201079804",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00074136",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSSBLUESHIELDS",
"identifier": "NM00Q036",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Alamos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.