Active NPI
Deborah P. Gardiner, PT, ATC, CHT
- Hand Physical Therapist
- Plattsburgh, NY
National Provider Identifier
1851335384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hand Physical Therapist
- License
- 010142-1
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004132015 | Medicaid | CT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 000299 | CT | MD | Emergency Medicine Physician |
| 003967 | CT | MD | Physical Therapist |
| 010142-1 | NY | MD | Physical Therapist |
| 002607-1 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Internal Medicine Physician
- Plattsburgh, NY
- NPI 1124189782
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.