Timothy Andrew Gardner, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20515 Issued in NE

Practice address

2444 W Faidley Ave
Grand Island, NE 68803-4327

Phone

(308) 382-1100

Fax

(308) 385-0796

NPI assigned

Jul 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothygardner@gici.allscriptsdirect.net

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.

• Grand Island Clinic Inc

  • Family Medicine Physician
  • Grand Island, NE
  • NPI 1598766735

  Pediatrics

  Medicare reassignment NPD
• Grand Island Clinic Inc

  • Clinical Medical Laboratory
  • Grand Island, NE
  • NPI 1003061912
  NPD (past)
• Grand Island Regional Medical Center

  • General Acute Care Hospital
  • Grand Island, NE
  • NPI 1558910604
  NPD (past)
• Saint Francis Medical Center

  • General Acute Care Hospital
  • Grand Island, NE
  • NPI 1982675955
  NPD (past)

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1376543322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688020550",
            "telephone_number": "308-382-1100",
            "fax_number": "308-385-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2444 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034327",
            "telephone_number": "308-382-1100",
            "fax_number": "308-385-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "TIMOTHY",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "20515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47017633037",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "34032",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "240082",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexa Isabel Garcia
• Daniel Garcia
• Jessica R Garcia
• Lori Ann Garcia
• Kayla M Gardient, PA-C
• Tyler Ryan Garrett, PT, DPT
• Bobbette Garris, LPN
• Kandace Garwood
• Sara Gasper, MSW, LMHP
• Zvisinei Patience Gatsi

• Pediatrics Physician in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Pediatrics Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.