Active NPI
Aleta Maria Gardner, M.D.
- Family Medicine Physician
- Jackson, GA
National Provider Identifier
1750575130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 046851
- Practice address
- 2978 Highway 36 W
Jackson, GA 30233 - Phone
- (770) 504-2168
- Fax
- (770) 504-2140
- NPI assigned
- Aug 29, 2007
- Last updated
- Aug 29, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 046851 | GA | Primary |
Addresses
Primary practice location
2978 Highway 36 W
Jackson, GA 30233
Mailing address
2978 Highway 36 W
Jackson, GA 30233
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046851 | GA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188345600000",
"number": "1750575130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2978 HIGHWAY 36 W",
"city": "JACKSON",
"state": "GA",
"postal_code": "30233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2978 HIGHWAY 36 W",
"city": "JACKSON",
"state": "GA",
"postal_code": "30233",
"telephone_number": "770-504-2168",
"fax_number": "770-504-2140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "ALETA",
"middle_name": "MARIA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-29",
"last_updated": "2007-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "046851",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, GA
- Joseph Fowlkes, MD
- Freds Stores of Tennessee Inc. (Big D's Discount Drug 3990)
- Regen Vachelle Freeman, M.A.,CCC-SLP
- Friendly Neighbors Als., Inc
- Ga Kidz Pediatrics. P.C.
- Kela Gates, APRN, FNP-C
- Georgia CVS Pharmacy LLC (CVS Pharmacy #04531)
- Georgia Diagnostic & Classification Prison Pharmacy
- Georgia Ophthalmologists LLC
- Jasmine Felice Gerald
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.