Jennifer Anne Gardner
Individual provider Active NPI Family Nurse Practitioner · Twin Falls, ID
NPI 1659979516 · NPPES record last updated Oct 13, 2020
Key facts
- NPI
- 1659979516
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 65975 (ID)
- Practice address
- 1385 Park View Dr Ste 101
Twin Falls, ID 83301-4390 - Phone
- (208) 944-0497
- Fax
- (208) 944-0506
- NPI assigned
- Oct 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family and Adolescent Care of Twin Falls PA
Practice addresses (Care Compare)
1385 Parkview Dr
Suite 101
Twin Falls, ID 83301-4084
Phone (208) 944-0497
Hospital & facility affiliations
- St Lukes Magic Valley Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210111002659 | ID | Practitioner - Nurse Practitioner | 9032522065 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65975 | ID | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 65975 | ID | Yes |
Addresses
Primary practice location
1385 Park View Dr Ste 101
Twin Falls, ID 83301-4390
Mailing address
160 7TH Ave N
Twin Falls, ID 83301-6145
Phone (208) 420-8387
Other providers in Twin Falls, ID
- Virginia Gambrel
- Christopher Aaron Ganz
- Deborah A Garbett
- Michael Garbett
- Eva Marie Garcia
- Theodore Gardner
- Paul Richard Garn
- Stephanie Garrison
- Gary P Walker OD PC
- Jessica Gaston
All providers in Twin Falls, ID · Family Nurse Practitioner in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.