John Russell Gardner, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

23872 Issued in NE

Practice address

601 N 30TH St
Omaha, NE 68131-2137

Phone

(402) 449-4590

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Professional Services PCGroup PAC ID 6901707272, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Estrella Medical Center Hospital, Phoenix, AZ, CCN 030115
• Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Emergency Professional Services PC

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1518984210
  Medicare reassignment Care Compare group NPD
• Emergency Professional Services PC

  • Emergency Medicine Physician
  • Apache Junction, AZ
  • NPI 1205273406
  NPD
• Emergency Professional Services PC

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1225055924
  NPD
• Omaha Emergency Physicians PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Omaha, NE
  • NPI 1023002771
  NPD (past)

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

• Banner - University Medical Center Phoenix

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1841224870
  Care Compare affiliation
• Banner Estrella Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1275566200
  Care Compare affiliation

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224460800000",
    "number": "1760570972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3366-0210",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681760210",
            "telephone_number": "866-321-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N 30TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312137",
            "telephone_number": "402-449-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JOHN",
        "middle_name": "RUSSELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NE",
            "license": "23872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNE",
            "identifier": "34348",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025121700",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "252841",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsey Gard
• Kelsey Gardipee
• Anthony Gardner
• Cassandra Gardner
• Glenn C Gardner, MD
• Megan Gardner, MA, SLP
• Patricia G Gardner
• Quadry Gardner
• Rita Philomena Gardner
• Rohini Garg, MD

• Emergency Medical Services (Emergency Medicine) Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.