Jessica Elena Gardner, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101249412 Issued in VA

Practice address

7021 Harbour View Blvd Ste 119
Suffolk, VA 23435-2869

Phone

(757) 953-7000

Fax

(757) 953-5025

NPI assigned

Jul 2, 2008

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jessica Elena Sharp Former name

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Childrens Medical Group Inc

  dba General Booth Pediatrics

  • Pediatrics Physician
  • Virginia Beach, VA
  • NPI 1366597114
  NPD (past)
• Childrens Medical Group Inc

  dba Tidewater Children's Associates

  • Pediatrics Physician
  • Norfolk, VA
  • NPI 1538214713
  NPD (past)
• Childrens Specialty Group PLLC

  • Pediatrics Physician
  • Norfolk, VA
  • NPI 1255354130
  NPD (past)

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1568625226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9514 N RIVER RD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353359",
            "telephone_number": "919-601-7707",
            "fax_number": "757-953-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7021 HARBOUR VIEW BLVD STE 119",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352869",
            "telephone_number": "757-953-7000",
            "fax_number": "757-953-5025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Childrens Ln",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071910",
            "country_code": "US",
            "telephone_number": "757-668-7272",
            "fax_number": "757-668-9766",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 John Paul Jones Cir",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082111",
            "country_code": "US",
            "telephone_number": "757-953-7021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JESSICA",
        "middle_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2023-03-07",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116021373",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2008015974",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101249412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SHARP",
            "middle_name": "ELENA",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mirellie Garcia-Padin, BCBA
• Nicole Garcia, BCABA
• William John Gardella, CRNA
• Amy Gardill, M.S. BCBA
• Gabrielle Elizabeth Gardner, BSN, RN
• Michael Gardner, D.O.
• Tonya D Gardner, LPC
• Daniel Wayne Garland, MD
• Lisa R Garrett, CCC-SLP
• Rosalyn Denaye Garrett, FNP

• Pediatrics Physician in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.