Individual provider Active NPI

David Allen Gardner Jr.

  • Acute Care Nurse Practitioner
  • Providence, RI
National Provider Identifier
1427537604
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN01860 Issued in RI
Practice address
593 Eddy Street
Apc Main
Providence, RI 02903
Phone
(401) 444-5435
Fax
(401) 444-8301
NPI assigned
Aug 9, 2018
Last updated
Sep 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN01860 RI Primary
Adult Health Nurse Practitioner 363LA2200X APRN01860 RI
Gerontology Nurse Practitioner 363LG0600X APRN01860 RI

Addresses

Primary practice location

593 Eddy Street
Apc Main
Providence, RI 02903

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4513
Phone (401) 444-6779

Other practice location 1

11 Friendship Street
Turner Building, 5th Floor
Newport, RI 02840
Phone (401) 845-1998

Other practice location 2

164 Summit Avenue
Fain Building
Providence, RI 02906
Phone (401) 793-2920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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

Enrollment IDStateProvider typePAC IDDetails
I20181017003509 RI Practitioner - Nurse Practitioner 1254683303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Practice addresses (Care Compare)

593 Eddy St
Apc 138
Providence, RI 02903-4900
Phone (401) 444-5435

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Sep 10, 2018 Accepting new patients
Lifespan Corporation Current Accepting new patients
Rhode Island Hospital CurrentSince Sep 10, 2018 Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

11 Friendship St
Bldg 5TH
Newport, RI 02840
Phone (401) 845-1998

407 East Ave
Ste 200
Pawtucket, RI 02860
Phone (401) 312-0023

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

593 Eddy St
Providence, RI 02903

593 Eddy St
#138
Providence, RI 02903
Phone (401) 444-5291

Interoperability endpoints

  • Direct secure messaging: dgardner160923@brownhealth.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1427537604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054513",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY STREET",
            "address_2": "APC MAIN",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02903",
            "telephone_number": "401-444-5435",
            "fax_number": "401-444-8301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Friendship Street",
            "address_2": "Turner Building, 5th Floor",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "RI",
            "postal_code": "02840",
            "country_code": "US",
            "telephone_number": "401-845-1998",
            "fax_number": "401-848-6510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "164 Summit Avenue",
            "address_2": "Fain Building",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "02906",
            "country_code": "US",
            "telephone_number": "401-793-2920",
            "fax_number": "401-793-2859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "RI",
            "license": "APRN01860",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "RI",
            "license": "APRN01860",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "RI",
            "license": "APRN01860",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.