Kelly Anne Gardner, RD,CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

011102 Issued in NY

Practice address

1 Atwell Rd
Cooperstown, NY 13326-1301

Phone

(607) 547-6665

NPI assigned

Aug 20, 2009

Last updated

Nov 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mary Imogene Bassett Hospital

  dba Bassett Medical Center

  • Multi-Specialty Clinic/Center
  • Cooperstown, NY
  • NPI 1083664221
  Medicare reassignment

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1730311036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "credential": "RD,CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-20",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "011102",
            "primary": true
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "MD",
            "license": "DO1266",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ricky A. Gabriel Baldwin, NP
• Anne Marie Gadomski, M.D.
• Sheila Gahan, F.N.P.
• Patricia A Gambitta, P.H.D
• Brandon Garcia, MD
• Anne Gartung, N.P.
• Jessica J Gaske, PNP
• Olivia Gates, RD
• Kiersten Pikarsky Gaunt, DO
• Peter J Gencarelli, M.D.

• Registered Dietitian in Cooperstown, NY
• Providers in Cooperstown, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.