Mark L Gardner, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

G73337 Issued in CA

Practice address

475 N Forbes St
Lakeport, CA 95453-4725

Phone

(707) 263-6346

Fax

(707) 263-5327

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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.

• Ukiah Adventist Hospital

  • General Acute Care Hospital
  • Ukiah, CA
  • NPI 1235120676
  Medicare reassignment NPD CA
• Ukiah Adventist Hospital

  • Community/Retail Pharmacy
  • Willits, CA
  • NPI 1629432968
  NPD
• Adventist Health California Medical Group, Inc.

  • Internal Medicine Physician
  • Saint Helena, CA
  • NPI 1437474269
  NPD (past)
• Tenet Florida Physician Services LLC

  • Surgery Physician
  • West Palm Beach, FL
  • NPI 1659417467
  NPD (past) Cardiovascular Disease

Medicare fee-for-service enrollment

Enrolled in CA

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 14, 2017.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513209600000",
    "number": "1811921174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 N FORBES ST",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954534725",
            "telephone_number": "707-263-6346",
            "fax_number": "707-263-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 N FORBES ST",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954534725",
            "telephone_number": "707-263-6346",
            "fax_number": "707-263-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MARK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2017-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME0065785",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G73337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine Fontana, PUBLIC HEALTH NURSE
• Leonardo Franco, M.A.
• Reyna From, B.S., M.S., PPS
• Megan Wray Furniss, D.O.
• Nicolas R Garcia
• Matthew J. Garrean, P.T.
• Allison Gatton
• Chelsie Toni Buenviaje Gho, NP
• Milcah Wanjiku Gichuru, FNP-BC
• Anju Goel, MD, MPH

• All providers in Lakeport, CA
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.