George Glenn Gardner, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2011020458 Issued in MO

Practice address

102 E. Main St
Adrian, MO 64720-9207

Phone

(816) 297-2640

NPI assigned

Mar 17, 2009

Last updated

Aug 1, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Citizens Memorial Healthcare

  • Surgery Physician
  • Bolivar, MO
  • NPI 1568566131

  Physician Assistant

  Medicare reassignment NPD
• Bates County Memorial Hospital

  dba BCMH Surgical Care Clinic

  • Surgery Physician
  • Butler, MO
  • NPI 1740311471
  Medicare reassignment
• Bates County Memorial Hospital

  dba Family Care Clinic Rich Hill

  • Rural Health Clinic/Center
  • Rich Hill, MO
  • NPI 1477009959
  NPD
• Bates County Memorial Hospital

  dba Family Care Clinic Adrian

  • Rural Health Clinic/Center
  • Adrian, MO
  • NPI 1578797494
  NPD
• Citizens Memorial Healthcare

  dba CMH Willard Medical Center

  • Rural Health Clinic/Center
  • Willard, MO
  • NPI 1568127397
  NPD
• Mawd Pathologists, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Lenexa, KS
  • NPI 1376209130
  NPD
• Mawd Pathology Group Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Lenexa, KS
  • NPI 1033108519
  NPD

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312156800000",
    "number": "1386885648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "BUTLER",
            "state": "MO",
            "postal_code": "647300370",
            "telephone_number": "660-200-7033",
            "fax_number": "660-200-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E. MAIN ST",
            "city": "ADRIAN",
            "state": "MO",
            "postal_code": "647209207",
            "telephone_number": "816-297-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "GEORGE",
        "middle_name": "GLENN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-17",
        "last_updated": "2011-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1706",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2011020458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Elizabeth Clayton
• D&S Health Partners, LLC
• D&S Health Partners, LLC (Summers Pharmacy of Adrian)
• Erma Louise Davis, CPTA
• Four Seasons of Adrian, LLC
• Tiffany Hendricks, LCSW
• Heidi Hendrickson, COTA/L
• Monique A Hill, COTA/L
• Lynn A Hines
• Bailie G Land, CPM

• Physician Assistant in Adrian, MO
• Providers in Adrian, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; 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.