Beverly Joan Gardner, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA632 Issued in TN

Practice address

131 S Webb Ave
Crossville, TN 38555-8452

Phone

(931) 484-5379

Fax

(931) 484-5946

NPI assigned

Aug 10, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acute Care Clnic Inc.Group PAC ID 8022338862, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Quality Home Health Home health agency, Jamestown, TN, CCN 447406
• Cumberland Medical Center Hospital, Crossville, TN, CCN 440009

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Acute Care Clnic Inc

  • Clinic/Center
  • Crossville, TN
  • NPI 1811392145
  Medicare reassignment Care Compare group
• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010
  Medicare reassignment NPD
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415
  NPD
• Crossville Medical Group PA

  • Multi-Specialty Clinic/Center
  • Crossville, TN
  • NPI 1053414698
  NPD (past)
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• All Care Plus Inc.

  • Home Health Agency
  • Jamestown, TN
  • NPI 1629073614
  Care Compare affiliation
• Cumberland Medical Center, Inc.

  • General Acute Care Hospital
  • Crossville, TN
  • NPI 1871596403
  Care Compare affiliation

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1629089065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 S WEBB AVE",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385558452",
            "telephone_number": "931-484-5379",
            "fax_number": "931-484-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 S WEBB AVE",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385558452",
            "telephone_number": "931-484-5379",
            "fax_number": "931-484-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "BEVERLY",
        "middle_name": "JOAN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "PA632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00239251",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alasondra Diana Freeborn, PA-C
• Courtney Freels, FNP
• Jenna Joan Friend, AU.D.
• Adam Fusco, D.M.D.
• Michael Stewart Galloway, M.D.
• Amanda Michelle Garman, M.D.
• Gary Wikert MD PLLC
• Honey Geer
• Genoa Healthcare LLC
• Elmer Rickey Gibbs, M.D.

• Medical Physician Assistant in Crossville, TN
• Providers in Crossville, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.