Individual provider Active NPI

Deborah P. Gardiner, PT, ATC, CHT

  • Hand Physical Therapist
  • Plattsburgh, NY
National Provider Identifier
1851335384
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Physical TherapistTaxonomy code 2251H1200X
License
010142-1 Issued in NY
Practice address
214 Cornelia St
Suite 103
Plattsburgh, NY 12901-2317
Phone
(518) 314-3371
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 003967 CT
Hand Physical Therapist 2251H1200X 003967 CT
Physical Therapist 225100000X 010142-1 NY
Hand Physical Therapist 2251H1200X 010142-1 NY Primary
Athletic Trainer 2255A2300X 002607-1 NY
Athletic Trainer 2255A2300X 000299 CT

Addresses

Primary practice location

214 Cornelia St
Suite 103
Plattsburgh, NY 12901-2317

Mailing address

PO Box 2868
Plattsburgh, NY 12901-0259
Phone (518) 562-4616

Other identifiers 1

IdentifierTypeStateIssuer
004132015MedicaidCT

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

State licenses

LicenseStateTypeSpecialty
000299CTMDEmergency Medicine Physician
003967CTMDPhysical Therapist
010142-1NYMDPhysical Therapist
002607-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Champlain Valley Physicians Hospital Medical Center Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1851335384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2868",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129010259",
            "telephone_number": "518-562-4616",
            "fax_number": "518-562-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 CORNELIA ST",
            "address_2": "SUITE 103",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012317",
            "telephone_number": "518-314-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDINER",
        "first_name": "DEBORAH",
        "middle_name": "P.",
        "credential": "PT, ATC, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "003967",
            "primary": false
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Hand",
            "state": "CT",
            "license": "003967",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010142-1",
            "primary": false
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Hand",
            "state": "NY",
            "license": "010142-1",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "002607-1",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CT",
            "license": "000299",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004132015",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.