Individual provider Active NPI

Sandra Yvonne Gardner

  • Home Health Agency
  • Saint Louis, MO
National Provider Identifier
1417028861
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
73832311898322 Issued in MO
Practice address
9953 Lewis and Clark Blvd Ste 106
Saint Louis, MO 63136-5336
Phone
(314) 868-4888
Fax
(314) 868-2291
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 73832311898322 MO Primary

Addresses

Primary practice location

9953 Lewis and Clark Blvd Ste 106
Saint Louis, MO 63136-5336

Mailing address

1250 Edgewater Dr
Saint Louis, MO 63137-1105
Phone (314) 868-4888

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

State licenses

LicenseStateTypeSpecialty
73832311898322MOMDHome Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Home Health Care Services of America Home Health Current Accepting new patients
Home Health Care Services of America Home Health Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417028861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 EDGEWATER DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631371105",
            "telephone_number": "314-868-4888",
            "fax_number": "314-868-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9953 LEWIS AND CLARK BLVD STE 106",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631365336",
            "telephone_number": "314-868-4888",
            "fax_number": "314-868-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "SANDRA",
        "middle_name": "YVONNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "73832311898322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.