Timothy John Gardner, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00019722 Issued in WA

Practice address

6120 N Mayfair St
Suite 101
Spokane, WA 99208-1033

Phone

(509) 489-7483

Fax

(509) 489-4572

NPI assigned

Oct 14, 2005

Last updated

Jan 25, 2010By the provider in NPPES

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 3

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

Locations

Interoperability endpoints

• Direct secure messaging: tgardner3264485@ghc.direct-ci.net

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.

• Northside Internal Medicine Associates PS

  • Internal Medicine Physician
  • Spokane, WA
  • NPI 1114966769
  NPD Authorized official
• Inland Empire Hospital Services Association

  dba Family Medicine of Spokane

  • Family Medicine Physician
  • Spokane, WA
  • NPI 1326002163
  NPD (past)
• Laboratory Corporation of America

  • Clinical Medical Laboratory
  • Walla Walla, WA
  • NPI 1972485621
  NPD (past)

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264377600000",
    "number": "1649269499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 N MAYFAIR ST",
            "address_2": "SUITE 101",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992081033",
            "telephone_number": "509-489-9483",
            "fax_number": "509-489-4572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 N MAYFAIR ST",
            "address_2": "SUITE 101",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992081033",
            "telephone_number": "509-489-7483",
            "fax_number": "509-489-4572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2010-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00019722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF IDAHO",
            "identifier": "10002943",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8457202",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZURIS",
            "identifier": "GA5801",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth L Gardner, RPH
• Margaret Ann Gardner, LMT
• Mark Owen Gardner, O.T.
• Olivia Katherine Gardner
• Shawnee Gardner, CDP, LACSW
• Melanie Garduno
• Tamara Garduno, MD
• Garland Dictrict Counseling Services PLLC
• Garland Vision Source, Inc.
• Sheree Garland, LPC

• Internal Medicine Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; 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.