Active NPI
H. Glenn Garner, M.D.
- Pediatrics Physician
- Mesa, AZ
National Provider Identifier
1417947003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 24441
- Practice address
- 1220 S Higley Rd
Suite 101
Mesa, AZ 85206-4000 - Phone
- (480) 615-2010
- Fax
- (480) 324-0950
- NPI assigned
- Oct 25, 2005
- Last updated
- Jun 10, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 24441 | AZ | Primary |
Addresses
Primary practice location
1220 S Higley Rd
Suite 101
Mesa, AZ 85206-4000
Mailing address
PO Box 16455
Mesa, AZ 85211-6455
Phone (480) 615-2075
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 356974 | Medicaid | AZ |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24441 | AZ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canyon Pediatrics, Inc | Pediatrics | Past | Accepting new patients |
| Banner Childrens Banner Health Clinic LLC | Past | Accepting new patients | |
| Canyon Pediatrics, Inc | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- howard.garner@canp.eclinicaldirectplus.com
- https://fhir4.healow.com/fhir/r4/GBGIBD
Organizations & group practices 3
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.
-
- Primary Care Clinic/Center
- Phoenix, AZ
- NPI 1407191216
-
- Pediatrics Physician
- Gilbert, AZ
- NPI 1053176677
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307664000000",
"number": "1417947003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16455",
"city": "MESA",
"state": "AZ",
"postal_code": "852116455",
"telephone_number": "480-615-2075",
"fax_number": "480-962-0523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 S HIGLEY RD",
"address_2": "SUITE 101",
"city": "MESA",
"state": "AZ",
"postal_code": "852064000",
"telephone_number": "480-615-2010",
"fax_number": "480-324-0950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARNER",
"first_name": "H.",
"middle_name": "GLENN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-25",
"last_updated": "2011-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "24441",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "356974",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.