Dustin J Gardner, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6041 Issued in OH

Practice address

105 Morey Dr
Marysville, OH 43040-1647

Phone

(937) 642-1916

NPI assigned

Aug 1, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ohio State University - College of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gardner Family Eyecare, LLCGroup PAC ID 2860826757, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gardner Family Eyecare, LLC

  • Optometrist
  • New Bremen, OH
  • NPI 1336781079
  Medicare reassignment Care Compare group NPD
• Clarkson Optometry Midwest Inc

  • Optometrist
  • Centerville, OH
  • NPI 1073917597
  Medicare reassignment NPD
• Clarkson Optometry Midwest Inc

  • Optometrist
  • Wooster, OH
  • NPI 1396325130
  NPD
• New Bremen Eyecare, LLC

  • Optometrist
  • New Bremen, OH
  • NPI 1831184472
  NPD

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1366720922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15933 CLAYTON RD",
            "address_2": "SUITE 201",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112172",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MOREY DR",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430401647",
            "telephone_number": "937-642-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "DUSTIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-01",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Fuller
• Valerie Fuller
• Amanda Ann Fulwider, MA, AT, ATC
• Gables at Green Pastures
• Mark Gallagher
• Kayla Marie Gardner, PA-C
• Katherine G Garretson, LSW
• Virginia Lynne Gates
• Kathryn Z Gathof, MD
• Steven Marc Gemma, M.D.

• Optometrist in Marysville, OH
• Providers in Marysville, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.