Organization Active NPI

Gardner Chiropractic Health and Rehabilitation LLC

  • Chiropractor
  • Westerville, OH
National Provider Identifier
1720268501
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3011 Issued in OH
Legal business name
GARDNER CHIROPRACTIC HEALTH AND REHABILITATION LLC
Practice address
805 Hillsdowne Rd
Suite B
Westerville, OH 43081-7308
Phone
(614) 794-9900
Fax
(614) 794-9977
NPI assigned
Nov 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Authorized official

Name
Jill C GardnerNPI 1154475978
Title
DC
Phone
(614) 794-9900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3011 OH Primary

Addresses

Primary practice location

805 Hillsdowne Rd
Suite B
Westerville, OH 43081-7308

Mailing address

805 Hillsdowne Rd
Suite B
Westerville, OH 43081-7308

Other identifiers 1

IdentifierTypeStateIssuer
2331784MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050707000865 OH Part B Supplier - Clinic/Group Practice 0345286654 Receives reassigned benefits from 1 practitioner
Practice locations: Westerville, OH

National Provider Directory

National Provider Directory

Locations

4 Huber VLG Blvd
Westerville, OH 43081
Phone (614) 794-9900

805 Hillsdowne Rd
Ste B
Westerville, OH 43081
Phone (614) 794-9900

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1720268501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 HILLSDOWNE RD",
            "address_2": "SUITE B",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430817308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 HILLSDOWNE RD",
            "address_2": "SUITE B",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430817308",
            "telephone_number": "614-794-9900",
            "fax_number": "614-794-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDNER CHIROPRACTIC HEALTH AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DC",
        "authorized_official_telephone_number": "614-794-9900"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2331784",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.