Mary Theresa Gardner, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN 230117 Issued in OH

Practice address

400 Wabash Ave
Akron, OH 44307-2433

Phone

(330) 344-6000

NPI assigned

Jun 21, 2005

Sex

Female

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Hollywood Diagnostic Center Inc

  • Clinical Medical Laboratory
  • Akron, OH
  • NPI 1639249410
  NPD (past)

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369353600000",
    "number": "1619973161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 W EXCHANGE ST",
            "address_2": "STE 220",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443021704",
            "telephone_number": "330-344-6401",
            "fax_number": "330-344-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WABASH AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443072433",
            "telephone_number": "330-344-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MARY",
        "middle_name": "THERESA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2013-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN 230117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS PIN",
            "identifier": "430028804",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0172147",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000023852",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline S Gardiner, NP
• Jelyn Laneer Gardner Burnside, STNA
• Hannah Gardner
• Judith Gardner, LISW
• Lauren Renee Gardner
• Anubhav Garg, MD
• Ryan Garich
• Jillian Rose Garland
• Krista Garland, PRS
• Jenna Garlock, PHARMD

• Certified Registered Nurse Anesthetist in Akron, OH
• Providers in Akron, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; 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.