Lilly M Gardner, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

179977 Issued in NY

Practice address

201 Houlton Road
Danforth, ME 04424

Phone

(207) 448-2347

Fax

(207) 448-2313

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• King County Public Hospital District No. 2

  • Physical Therapist
  • Kirkland, WA
  • NPI 1356920946
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230076800000",
    "number": "1487749388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HOULTON ROAD",
            "city": "DANFORTH",
            "state": "ME",
            "postal_code": "04424",
            "telephone_number": "207-448-2347",
            "fax_number": "207-448-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HOULTON ROAD",
            "city": "DANFORTH",
            "state": "ME",
            "postal_code": "04424",
            "telephone_number": "207-448-2347",
            "fax_number": "207-448-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "LILLY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "179977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104590000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CSD #12 - East Range II
• Danforth Habilitation Association
• East Grand Health Center, Inc
• East Range II
• Henry Fisk, MD
• Leslee Smith Mahon, LCPC-C
• Maine Family Resource Center
• Maine Family Resource Center
• Lyndsay R McIver, CNP
• Casey Quint

• Family Medicine Physician in Danforth, ME
• Providers in Danforth, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2008; 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.