Active NPI
Ross E Gardner, MD
- Otolaryngology Physician
- Birmingham, AL
National Provider Identifier
1770572810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 11281
- Practice address
- 401 Tuscaloosa Avenue SW
Birmingham, AL 35211-1486 - Phone
- (205) 780-9655
- Fax
- (205) 780-9623
- NPI assigned
- Oct 20, 2005
- Last updated
- Oct 8, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 00011281 | AL | |
| Otolaryngology Physician | 207Y00000X | 11281 | AL | Primary |
Addresses
Primary practice location
401 Tuscaloosa Avenue SW
Birmingham, AL 35211-1486
Mailing address
401 Tuscaloosa Avenue SW
Birmingham, AL 35211-1486
Phone (205) 780-9655
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000013673 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041214001099 | AL | Practitioner - Otolaryngology | 8527025238 | Practice locations: Birmingham, AL |
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Meharry Medical College School of Medicine, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
401 Tuscaloosa Swave
Birmingham, AL 35211-1416
Phone (205) 780-9655
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00011281 | AL | MD | Otolaryngology Physician |
| 11281 | AL | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Medical Eye Ophthalmic Care | Past | Accepting new patients |
Networks
- bcbs alabama network 01H0
- bcbs alabama network 01I0
- bcbs alabama network 01E0
- bcbs alabama network 01A0
- bcbs alabama network 01B0
- bcbs alabama network 01G0
Organizations & group practices 1
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.
-
- Ophthalmology Physician
- Birmingham, AL
- NPI 1518264258
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570492800000",
"number": "1770572810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 TUSCALOOSA AVENUE SW",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352111486",
"telephone_number": "205-780-9655",
"fax_number": "205-780-9623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 TUSCALOOSA AVENUE SW",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352111486",
"telephone_number": "205-780-9655",
"fax_number": "205-780-9623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "ROSS",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-20",
"last_updated": "2019-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "AL",
"license": "00011281",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "AL",
"license": "11281",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000013673",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.