Active NPI
Lisa L Gardner, DO
- Obstetrics & Gynecology Physician
- Fort Worth, TX
National Provider Identifier
1477578292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- L9698
- Practice address
- 7250 Hawkins View Dr
Ste 411
Fort Worth, TX 76132-3920 - Phone
- (817) 644-1758
- Fax
- (817) 644-3112
- NPI assigned
- Jul 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | L9698 | TX | Primary |
Addresses
Primary practice location
7250 Hawkins View Dr
Ste 411
Fort Worth, TX 76132-3920
Mailing address
7250 Hawkins View Dr
Ste 411
Fort Worth, TX 76132-3920
Phone (817) 644-1758
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 172373602 | Medicaid | TX | |
| P00364785 | Other | RAILROAD MEDICARE |
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 Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L9698 | TX | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urology Partners of North Texas, PLLC | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/18f5d65c-83f0-435a-868c-70ce5a6de90a/
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 and National Provider Directory roles.
-
- Urology Physician
- Arlington, TX
- NPI 1528537180
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351036800000",
"number": "1477578292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7250 HAWKINS VIEW DR",
"address_2": "STE 411",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761323920",
"telephone_number": "817-644-1758",
"fax_number": "817-644-3112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7250 HAWKINS VIEW DR",
"address_2": "STE 411",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761323920",
"telephone_number": "817-644-1758",
"fax_number": "817-644-3112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "LISA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-13",
"last_updated": "2012-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "TX",
"license": "L9698",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "172373602",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00364785",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.