Individual provider Active NPI

Julie Beth Gardner, MD

  • Internal Medicine Physician
  • De Witt, AR
National Provider Identifier
1639674690
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E-15010 Issued in AR
Practice address
1703 S Whitehead Dr
De Witt, AR 72042-2911
Phone
(870) 946-0300
Fax
(870) 946-0303
NPI assigned
Mar 29, 2018
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-15010 AR Primary
Pediatrics Physician 208000000X E-15010 AR

Addresses

Primary practice location

1703 S Whitehead Dr
De Witt, AR 72042-2911

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (870) 946-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20220713002720 AR Practitioner - Pediatric MedicinePractitioner - Internal Medicine 8022364660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stuttgart Medical Clinic, LTDGroup PAC ID 8123176658, 10 clinicians
Baptist Health HospitalsGroup PAC ID 3870659246, shared by 9 NPIs, 5 clinicians

Practice addresses (Care Compare)

1609 N Medical Dr
Stuttgart, AR 72160-3274
Phone (870) 673-7395

1703 N Buerkle St
BHMC Stuttgart
Stuttgart, AR 72160-3153
Phone (870) 673-3511

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stuttgart Medical Clinic, LTD CurrentSince Jul 18, 2022 Accepting new patients
Stuttgart Regional Medical Center Past Accepting new patients

Locations

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

1609 N Medical Dr
Stuttgart, AR 72160
Phone (501) 673-7211

Interoperability endpoints

  • Direct secure messaging: jgardner585517@direct.baptist-healthar.org

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1639674690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "870-946-0300",
            "fax_number": "870-946-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S WHITEHEAD DR",
            "city": "DE WITT",
            "state": "AR",
            "postal_code": "720422911",
            "telephone_number": "870-946-0300",
            "fax_number": "870-946-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JULIE",
        "middle_name": "BETH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-15010",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-15010",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in De Witt, AR

Sources for this page

Verify at the official NPI Registry.