Kedisha Ruchel Gardener, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71012558A Issued in IN

Practice address

600 Trail Ridge Rd
Albion, IN 46701-1541

Phone

(260) 440-0168

NPI assigned

May 18, 2022

Last updated

May 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pike Medical Consultants PCGroup PAC ID 1850495003, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pike Medical Consultants PC

  • Pulmonary Disease Physician
  • Indianapolis, IN
  • NPI 1770689242
  Medicare reassignment Care Compare group NPD
• Informe Healthcare LLC

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1407343965

  Family, IN

  Medicare reassignment NPD
• Informe Healthcare TN, LLC

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1275003295
  NPD (past)

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1831836170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 ANCONIA CV",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468450138",
            "telephone_number": "260-440-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 TRAIL RIDGE RD",
            "city": "ALBION",
            "state": "IN",
            "postal_code": "467011541",
            "telephone_number": "260-440-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDENER",
        "first_name": "KEDISHA",
        "middle_name": "RUCHEL",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012558A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DRS. Roush & Will Optometrists Inc
• Rebecca Dundon, MSED
• Michael R. Engle, D.O.
• Sage Evans
• Fischer Pharmacare, LLC
• Mary Beth Getty, MSW, LCSW,LCAC
• Peter W Gross III, MSW, LCSW
• Mariel T Grove
• Donna Hackman, NP-C
• Stephanie R Hammer

• Family Nurse Practitioner in Albion, IN
• Providers in Albion, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.