Individual provider Active NPI

Ashley Gardner, MD

  • Psychiatry Physician
  • Wylie, TX
National Provider Identifier
1619364569
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
S0453 Issued in TX
Practice address
404 S Jackson Ave Suite 102
Wylie, TX 75098
Phone
(214) 997-4459
Fax
(972) 848-8592
NPI assigned
Apr 17, 2015
Last updated
Jan 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X S0453 TX Primary

Addresses

Primary practice location

404 S Jackson Ave Suite 102
Wylie, TX 75098

Mailing address

1313 Elm Dr
Wylie, TX 75098-4833
Phone (214) 997-4459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20240122000755 TX Practitioner - Psychiatry 8426400854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Texas a & M University System, HSC, College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathway Psychiatry and Counseling Center, PLLCGroup PAC ID 7517319940, 3 clinicians

Practice addresses (Care Compare)

404 S Jackson Ave
Suite 102
Wylie, TX 75098-3983
Phone (214) 997-4459

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
S0453TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathway Psychiatry and Counseling Center, PLLC Psychiatry CurrentSince Nov 10, 2023 Accepting new patients

Locations

211 Masters Ave
Ste 102
Wylie, TX 75098

404 S Jackson Ave
Apt 102
Wylie, TX 75098
Phone (214) 997-4459

611 S Highway 78
Ste 133
Wylie, TX 75098
Phone (347) 553-5056

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1619364569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 ELM DR",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750984833",
            "telephone_number": "214-997-4459",
            "fax_number": "972-848-8592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 S JACKSON AVE SUITE 102",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "75098",
            "telephone_number": "214-997-4459",
            "fax_number": "972-848-8592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "ASHLEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-17",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "S0453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wylie, TX

Sources for this page

Verify at the official NPI Registry.