Active NPI
Richard D Gardner, PA-C
- Physician Assistant
- Huntington, WV
National Provider Identifier
1770544967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 140
- Practice address
- 1415 6TH Ave
Huntington, WV 25701-2420 - Phone
- (304) 523-1142
- Fax
- (304) 523-2966
- NPI assigned
- Mar 29, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 140 | WV | Primary |
Addresses
Primary practice location
1415 6TH Ave
Huntington, WV 25701-2420
Mailing address
1415 6TH Ave
Huntington, WV 25701-2420
Phone (304) 523-1142
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1770544967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1415 6TH AVE",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257012420",
"telephone_number": "304-523-1142",
"fax_number": "304-523-2966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 6TH AVE",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257012420",
"telephone_number": "304-523-1142",
"fax_number": "304-523-2966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "RICHARD",
"middle_name": "D",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-29",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WV",
"license": "140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.