Active NPI
Mattea Gardner
- Specialist
- Fergus Falls, MN
National Provider Identifier
1346926276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 1806 Fir Ave E Suite 200
Fergus Falls, MN 56537 - Phone
- (218) 287-4338
- NPI assigned
- Jun 26, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
1806 Fir Ave E Suite 200
Fergus Falls, MN 56537
Mailing address
1547 30TH Ave S
Moorhead, MN 56560
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1346926276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1547 30TH AVE S",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "56560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1806 FIR AVE E SUITE 200",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "56537",
"telephone_number": "218-287-4338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "MATTEA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-26",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fergus Falls, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.