Henry Jerry Gardner, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1504831205 Issued in UT

Practice address

8900 SE 165TH Mulberry LN
The Villages, FL 32162-5884

Phone

(352) 674-5000

Fax

(352) 674-5031

NPI assigned

Jul 25, 2006

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

Other identifiers 1

Other names 1

• H Jerry Gardner Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1609899293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11248 N PARK DR",
            "city": "HIGHLAND",
            "state": "UT",
            "postal_code": "840039611",
            "telephone_number": "801-369-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 SE 165TH MULBERRY LN",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321625884",
            "telephone_number": "352-674-5000",
            "fax_number": "352-674-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "HENRY",
        "middle_name": "JERRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "1504831205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "990177709006",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "H",
            "last_name": "GARDNER",
            "middle_name": "JERRY",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• William Earl Galley, MA. CCC-SLP
• Andrea Kaye Galloway, MD
• Jerry Gao, DMD
• Hector L Garcia, M.D.
• Nestor Samuel Garcia, M.D.
• Garner Environmental Services, Inc.
• Ines Matilde Garrido, PT
• Enayat N Gashti, MD
• Heather M Gates, PA-C
• Florian Gegaj, M.D.

• Family Medicine Physician in The Villages, FL
• Providers in The Villages, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.