Timothy Martin Gardner, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

044037 Issued in MO

Practice address

490 Medical Drive
Ash Grove, MO 65604

Phone

(417) 751-2111

Fax

(417) 751-3112

NPI assigned

Feb 18, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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.

• Ash Grove Pharmacy Inc

  • Community/Retail Pharmacy
  • Ash Grove, MO
  • NPI 1053425025
  NPD (past)

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1497400394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 TOWN LOOP",
            "city": "MARSHFIELD",
            "state": "MO",
            "postal_code": "657067549",
            "telephone_number": "417-844-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 MEDICAL DRIVE",
            "city": "ASH GROVE",
            "state": "MO",
            "postal_code": "65604",
            "telephone_number": "417-751-2111",
            "fax_number": "417-751-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "TIMOTHY",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "044037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Ash Grove, MO
• Providers in Ash Grove, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.