Active NPI
Daniel Gardner, DO
- Family Medicine Physician
- Charleston, SC
National Provider Identifier
1851038673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- LL87576
- Practice address
- 169 Ashley Avenue
Room 202 Main Hospital
Charleston, SC 29425 - Phone
- (740) 466-6803
- NPI assigned
- May 13, 2022
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | LL87576 | SC | Primary |
Addresses
Primary practice location
169 Ashley Avenue
Room 202 Main Hospital
Charleston, SC 29425
Mailing address
169 Ashley Ave
Room 202 Main Hospital MSC 333
Charleston, SC 29425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL87576 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652400000000",
"number": "1851038673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 ASHLEY AVE",
"address_2": "ROOM 202 MAIN HOSPITAL MSC 333",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 ASHLEY AVENUE",
"address_2": "ROOM 202 MAIN HOSPITAL",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29425",
"telephone_number": "740-466-6803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "DANIEL",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-13",
"last_updated": "2022-05-13",
"certification_date": "2022-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "LL87576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.