Active NPI
Jason Gardner, R.PH.
- Pharmacist
- Brooklyn, NY
National Provider Identifier
1427371939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 050651
- Practice address
- 104 Jay St
Brooklyn, NY 11201-1569 - Phone
- (718) 246-4100
- Fax
- (718) 246-2417
- NPI assigned
- Mar 11, 2010
- Last updated
- Feb 21, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 050651 | NY | Primary |
| Pharmacist | 183500000X | 9464 | SC | |
| Pharmacist | 183500000X | 16298 | LA |
Addresses
Primary practice location
104 Jay St
Brooklyn, NY 11201-1569
Mailing address
104 Jay St
Brooklyn, NY 11201-1569
Phone (718) 246-4100
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16298 | LA | MD | Pharmacist |
| 050651 | NY | MD | Pharmacist |
| 9464 | SC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nyco Chemists Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392940800000",
"number": "1427371939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 JAY ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112011569",
"telephone_number": "718-246-4100",
"fax_number": "718-246-2417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 JAY ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112011569",
"telephone_number": "718-246-4100",
"fax_number": "718-246-2417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "JASON",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-11",
"last_updated": "2014-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "050651",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "9464",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "16298",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.