Timothy Lee Gardner, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

38003 Issued in TN

Practice address

1009 N State of Franklin Access Rd
Johnson City, TN 37604-3693

Phone

(423) 929-7546

Fax

(423) 929-7968

NPI assigned

Oct 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Virginia School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Dermatology of Gloucester, LLCGroup PAC ID 8325398043, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rappahannock General Hospital Hospital, Kilmarnock, VA, CCN 491308
• Riverside Walter Reed Hospital Hospital, Gloucester, VA, CCN 490130

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Integrated Dermatology of Gloucester, LLC

  • Dermatology Physician
  • Gloucester, VA
  • NPI 1710479936
  Medicare reassignment Care Compare group NPD
• Dermatology Consultants of Gloucester P L L C

  • Specialist
  • Gloucester, VA
  • NPI 1568674133

  Dermatology

  NPD
• Knoxville Dermatology Group PC

  • Dermatology Physician
  • Knoxville, TN
  • NPI 1760419014
  NPD (past)

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

• Chesapeake Hospital LLC

  dba Rappahannock General Hospital

  • Critical Access Hospital
  • Kilmarnock, VA
  • NPI 1699125526
  Care Compare affiliation
• Riverside Middle Peninsula Hospital Inc

  dba Riverside Walter Reed Hospital

  • General Acute Care Hospital
  • Gloucester, VA
  • NPI 1528162534
  Care Compare affiliation

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243814400000",
    "number": "1861482465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 N STATE OF FRANKLIN ACCESS RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043693",
            "telephone_number": "423-929-7546",
            "fax_number": "423-929-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 N STATE OF FRANKLIN ACCESS RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043693",
            "telephone_number": "423-929-7546",
            "fax_number": "423-929-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "TIMOTHY",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2009-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "38003",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "TN",
            "license": "38003",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "TN",
            "license": "38003",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Carmina Castillo Garcia, M.D.
• Michele Garcia, LMSW
• Emily Jackson Gardner
• Robert J Gardner, MSN
• Sarah Leigh Gardner
• Benjamin Hunter Garland, SOCIAL WORKER
• Brandy Michelle Garland, MAT
• Mary R. Garland, CRNA
• Tyler Daniel Garland
• Jessica Garrett, PTA

• Dermatology Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Dermatology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; 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.