NPIMap

Individual provider Active NPI

Timothy B Gardner, MD

  • Gastroenterology Physician
  • Lebanon, NH
National Provider Identifier
1851387229
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
11794 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(605) 650-5000
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 042-0010476 VT
Gastroenterology Physician 207RG0100X 49986 MN
Gastroenterology Physician 207RG0100X 138343 MT
Gastroenterology Physician 207RG0100X 11794 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Other practice location 1

1101 26th St S
Great Falls, MT 59405-5161
Phone (406) 731-8888

Other identifiers 4

IdentifierTypeStateIssuer
3077317MedicaidNH
352155000MedicaidMN
1009382MedicaidVT
P00427363OtherMNMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, VT, MT3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20060215000145 NH Practitioner - GastroenterologyPractitioner - Internal Medicine 2163437906 Reassigns benefits to 4 organizations
I20211213002528 VT Practitioner - Internal MedicinePractitioner - Gastroenterology 2163437906 Reassigns benefits to 1 organization
I20240424004023 MT Practitioner - Gastroenterology 2163437906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Connecticut School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, shared by 2 NPIs, 1,445 clinicians
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians
Southwestern Vermont Medical Center, IncGroup PAC ID 0143138446, 174 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

100 Hitchcock Way
Manchester, NH 03104-4125
Phone (603) 695-2500

140 Hospital Dr
Suite 307
Bennington, VT 05201-5018
Phone (802) 442-7881

PO Box
Suite 810
Hanover, NH 03755-0810

Hospital & facility affiliations

  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003
  • Benefis Hospitals Inc Hospital, Great Falls, MT, CCN 270012
  • New London Hospital Hospital, New London, NH, CCN 301304
  • Alice Peck Day Memorial Hospital Hospital, Lebanon, NH, CCN 301305
  • Southwestern Vermont Medical Center Hospital, Bennington, VT, CCN 470012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy122
Upper gastrointestinal (GI) endoscopy for acid reflux414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0010476VTMDInternal Medicine Physician
49986MNMDGastroenterology Physician
138343MTMDGastroenterology Physician
11794NHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The New London Hospital Association, Inc. CurrentSince Jun 9, 2015 Accepting new patients
Dartmouth-Hitchcock Clinic Internal Medicine CurrentSince Apr 1, 2003 Accepting new patients
The New London Hospital Association, Inc. Internal Medicine CurrentSince Jun 9, 2015 Accepting new patients
Mary Hitchcock Memorial Hospital Internal Medicine Current Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Apr 1, 2003 Accepting new patients
Southwestern Vermont Medical Center Inc. CurrentSince Nov 1, 2021 Accepting new patients
Dartmouth-Hitchcock Clinic Internal Medicine CurrentSince Jan 12, 2012 Accepting new patients
Southwestern Vermont Medical Center Inc. Internal Medicine CurrentSince Nov 1, 2021 Accepting new patients
Benefis Hospitals Inc CurrentSince Apr 10, 2024 Accepting new patients
Mary Hitchcock Memorial Hospital Internal Medicine CurrentSince Apr 1, 2003 Accepting new patients
The New London Hospital Association, Inc. Past Accepting new patients
Upper Connecticut Valley Hospital Association Past Accepting new patients

Locations

2800 11th Ave S
Ste 12
Great Falls, MT 59405
Phone (406) 761-3556

1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

1645 Vandelay Ave
Ste 301
Helena, MT 59601
Phone (406) 389-2520

1645 Vandelay Ave
Ste 201
Helena, MT 59601
Phone (406) 389-2505

25 S River Rd
Bedford, NH 03110
Phone (603) 626-4392

253 Pleasant St
Concord, NH 03301
Phone (603) 226-2200

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

100 Hitchcock Way
Manchester, NH 03104
Phone (603) 629-1870

273 County Rd
New London, NH 03257
Phone (603) 526-5215

140 Hospital Dr
Ste 307
Bennington, VT 05201
Phone (802) 447-2229

100 Hospital Dr
#44
Bennington, VT 05201
Phone (802) 442-4509

140 Hospital Dr
Ste 116
Bennington, VT 05201
Phone (802) 447-1836

289 County Rd
Windsor, VT 05089
Phone (802) 674-7220

Interoperability endpoints

  • Direct secure messaging: tgardner12946@direct.dartmouth-hitchcock.org

Organizations & group practices 12

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1851387229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "605-650-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 26th St S",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594055161",
            "country_code": "US",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "TIMOTHY",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "042-0010476",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "49986",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MT",
            "license": "138343",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NH",
            "license": "11794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3077317",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352155000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009382",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00427363",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.