NPIMap

Individual provider Active NPI

Jacqueline Ashley Gardner, PA-C

  • Physician Assistant
  • Littleton, CO
National Provider Identifier
1720621964
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.005975 Issued in CO
Practice address
8155 Piney River Ave
Littleton, CO 80125-8728
Phone
(303) 265-3370
Fax
(303) 265-3371
NPI assigned
Oct 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.005975 CO Primary
Physician Assistant 363A00000X 00005975 CO

Addresses

Primary practice location

8155 Piney River Ave
Littleton, CO 80125-8728

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211004001584 CO Practitioner - Physician Assistant 2163820259 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

5589 Argonne St
Denver, CO 80249-8989
Phone (720) 516-8805

9475 S University Blvd
Uchealth Primary/Urgent Care Highlands Ranc
Highlands Ranch, CO 80126-7802
Phone (303) 470-4071

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
00005975COMDPhysician Assistant
PA.005975COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jul 3, 2023 Accepting new patients
Denver Health and Hospital Authority CurrentSince Oct 1, 2021 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 3, 2023 Accepting new patients
Denver Health and Hospital Authority CurrentSince Oct 1, 2021 Accepting new patients
Uchealth Community Services PastSince May 14, 2023 Accepting new patients

Locations

15240 W 64th Ave
Arvada, CO 80007
Phone (303) 463-7180

16951 E Quincy Ave
Aurora, CO 80015
Phone (303) 752-5470

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

4404 Barranca Ln
Ste 101
Castle Rock, CO 80104
Phone (720) 733-5260

777 Bannock St
Denver, CO 80204

5589 Argonne St
Denver, CO 80249
Phone (303) 371-0330

311 Steele St
Denver, CO 80206
Phone (303) 372-4000

4660 Yosemite St
Ste 100
Denver, CO 80238
Phone (720) 516-8900

9475 S University Blvd
Highlands Ranch, CO 80126
Phone (303) 470-4061

8155 Piney River Ave
Ste 100
Littleton, CO 80125
Phone (303) 265-3370

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

13631 Colorado Blvd
Thornton, CO 80602
Phone (303) 252-2960

Interoperability endpoints

  • Direct secure messaging: jgardner258046@direct.dhha.org

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 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1720621964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4123",
            "fax_number": "970-490-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8155 PINEY RIVER AVE",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801258728",
            "telephone_number": "303-265-3370",
            "fax_number": "303-265-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JACQUELINE",
        "middle_name": "ASHLEY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.005975",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "00005975",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.