Individual provider Active NPI

Jason Gardiner, MD

  • Emergency Medicine Physician
  • Macon, GA
National Provider Identifier
1861596033
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
52825 Issued in GA
Practice address
777 Hemlock St
HB 64
Macon, GA 31201-2102
Phone
(478) 633-2097
Fax
(478) 633-7836
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 52825 GA Primary

Addresses

Primary practice location

777 Hemlock St
HB 64
Macon, GA 31201-2102

Mailing address

203 Fishermans CV
Lizella, GA 31052-3326
Phone (478) 935-9777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20040109000166 GA Practitioner - Emergency Medicine 5698675478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Mercer University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Georgia Emergency Group LLCGroup PAC ID 5991004608, 27 clinicians

Practice addresses (Care Compare)

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-1000

Hospital & facility affiliations

  • Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
99.18
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52825GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Georgia Emergency Group, LLC Emergency Medicine CurrentSince May 1, 2016 Accepting new patients
Morningside Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Swift Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine Past Accepting new patients
Summit Macon LLC Past Accepting new patients
Emergency Medicine Physicians of Carteret County, PLLC Emergency Medicine Past Accepting new patients

Locations

777 Hemlock St
#64
Macon, GA 31201
Phone (478) 633-2097

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 6

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861596033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 FISHERMANS CV",
            "city": "LIZELLA",
            "state": "GA",
            "postal_code": "310523326",
            "telephone_number": "478-935-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "address_2": "HB 64",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-633-2097",
            "fax_number": "478-633-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDINER",
        "first_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "52825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.