Kenneth Gardner, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8980 Issued in ID

Practice address

2005 12TH Ave Rd
Nampa, ID 83686-6311

Phone

(208) 463-0022

Fax

(208) 463-0031

NPI assigned

Apr 22, 2019

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

Medicare fee-for-service enrollment

Enrolled in CA, ID2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

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.

• Peak Physical Therapy P C

  • Physical Therapist
  • Boise, ID
  • NPI 1073551560
  Medicare reassignment NPD
• All Star Physical Therapy

  • Physical Therapist
  • Murrieta, CA
  • NPI 1750559431
  Medicare reassignment NPD
• Idaho Physical Therapy Inc.

  • Physical Therapist
  • Nampa, ID
  • NPI 1427103837
  NPD
• Institute of Physical Therapy and Fitness

  • Physical Therapist
  • Lewiston, ID
  • NPI 1043392087
  NPD (past)

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1699338939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "951-374-7288",
            "fax_number": "951-666-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866311",
            "telephone_number": "208-463-0022",
            "fax_number": "208-463-0031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2780 E Barnett Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975048674",
            "country_code": "US",
            "telephone_number": "541-779-6250",
            "fax_number": "541-772-2531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "KENNETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-22",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "8980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernesto A Garcia Rosales
• Dustin Joseph Garcia, PHARMD
• Melissa Garcia, RN
• Gardner Dental LLC (Family Dental Center)
• Aubree Gardner, LPC
• Laurel M Gardner, PA-C
• Lavelle Sachi Gardner
• Michelle Huffman Gardner, MD
• Nathan Gardner
• Scott R Gardner, DDS

• Physical Therapist in Nampa, ID
• Providers in Nampa, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.