Active NPI
Joshua Gardiner, BS, LAT, ATC
- Sports Medicine (Emergency Medicine) Physician
- Pueblo, CO
National Provider Identifier
1750157103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Emergency Medicine) Physician
- License
- AT.0002391
- Practice address
- 2200 Bonforte Blvd
Pueblo, CO 81001-4901 - Phone
- (720) 737-4856
- NPI assigned
- Nov 28, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Emergency Medicine) Physician | 207PS0010X | AT.0002391 | CO | Primary |
Addresses
Primary practice location
2200 Bonforte Blvd
Pueblo, CO 81001-4901
Mailing address
2824 Airport Rd Apt 119
Colorado Springs, CO 80910-3007
Phone (518) 256-5507
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT.0002391 | CO | MD | Sports Medicine (Emergency Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701129600000",
"number": "1750157103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2824 AIRPORT RD APT 119",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809103007",
"telephone_number": "518-256-5507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 BONFORTE BLVD",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810014901",
"telephone_number": "720-737-4856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDINER",
"first_name": "JOSHUA",
"credential": "BS, LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-11-28",
"last_updated": "2023-11-28",
"certification_date": "2023-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "207PS0010X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Sports Medicine",
"state": "CO",
"license": "AT.0002391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.