Harriette Gardner

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

31 W Adams St
Ste 102
Jacksonville, FL 32202-3605

Phone

(901) 338-5421

NPI assigned

Jun 6, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Community Rehabilitation Center

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1306186846
  NPD (past) Authorized official
• H2H Support Services

  • Early Intervention Provider Agency
  • Jacksonville, FL
  • NPI 1942665187
  NPD (past) Authorized official

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1366645673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W 70TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322083810",
            "telephone_number": "901-338-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W ADAMS ST",
            "address_2": "STE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322023605",
            "telephone_number": "901-338-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "HARRIETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008048000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Audrey Y Gardner
• Brian Ross Gardner, APRN
• Carmella C Gardner, LMHC
• Dana Gardner, RD LDN
• Darren Rashaud Gardner
• Joy Ashley Gardner, M. ED, CCC-SLP
• Kimberly Alexis Gardner
• Mindi Dawson Gardner, MSW, LCSW, CBHCMS
• Nancy Windham Gardner, FNP
• Patnesha Marie Gardner

• Community/Behavioral Health Agency in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.