Individual provider Active NPI

Danielle Gardner, AA

  • Anesthesiologist Assistant
  • Saint Louis, MO
National Provider Identifier
1669022067
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
615 S New Ballas Rd Dept of
Saint Louis, MO 63141-8221
Phone
(314) 251-6000
Fax
(636) 386-7679
NPI assigned
Sep 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiologist Assistant 367H00000X Primary

Addresses

Primary practice location

615 S New Ballas Rd Dept of
Saint Louis, MO 63141-8221

Mailing address

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8980

Other practice location 1

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8980

Other names 1

  • Danielle Ravancho Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230929000750 DC Practitioner - Anesthesiology Assistant 7719314392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Indiana University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

110 Irving St NW
Washington, DC 20010-3017
Phone (202) 877-7000

Hospital & facility affiliations

  • Medstar Washington Hospital Center Hospital, Washington, DC, CCN 090011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Sentry Anesthesia Management, LLC CurrentSince Jul 22, 2021 Accepting new patients
Anesthesia Consultants of Savannah, PC CurrentSince Mar 5, 2020 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Sep 15, 2023 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Sep 15, 2023 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3007 Tilden St NW
Ste 5N
Washington, DC 20008

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

459 Highway 119 S
Springfield, GA 31329
Phone (912) 754-0200

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1669022067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-8980",
            "fax_number": "678-940-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD DEPT OF",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6000",
            "fax_number": "636-386-7679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-350-8980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-17",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "RAVANCHO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.