Active NPI
Casey Gardner, RDH
- Dental Hygienist
- Fort Campbell, KY
National Provider Identifier
1528418506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 4531
- Practice address
- 3603 Indiana Ave
Fort Campbell, KY 42223-5803 - Phone
- (270) 798-3544
- Fax
- (270) 956-0266
- NPI assigned
- Jun 21, 2016
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 4531 | KY | Primary |
Addresses
Primary practice location
3603 Indiana Ave
Fort Campbell, KY 42223-5803
Mailing address
2441 21St St
Fort Campbell, KY 42223-5582
Phone (270) 798-8751
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4531 | KY | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654560000000",
"number": "1528418506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2441 21ST ST",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235582",
"telephone_number": "270-798-8751",
"fax_number": "270-956-0266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3603 INDIANA AVE",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235803",
"telephone_number": "270-798-3544",
"fax_number": "270-956-0266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "CASEY",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-21",
"last_updated": "2022-06-07",
"certification_date": "2022-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "KY",
"license": "4531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.