Individual provider Active NPI

Patricia Gardner, MD

  • Emergency Medicine Physician
  • Michigan City, IN
National Provider Identifier
1871643791
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01051974A Issued in IN
Practice address
301 W Homer St
Michigan City, IN 46360-4358
Phone
(219) 877-1616
Fax
(219) 877-2007
NPI assigned
Jan 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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 01051974A IN Primary

Addresses

Primary practice location

301 W Homer St
Michigan City, IN 46360-4358

Mailing address

3316 Potomac CT
Naples, FL 34120-4474
Phone (239) 352-8050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170718001311 FL Practitioner - Emergency Medicine 0840223889 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Human Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thse - Marco Urgent Care LLCGroup PAC ID 8921131475, 19 clinicians

Practice addresses (Care Compare)

40 S Heathwood Dr
Marco Island, FL 34145-5026
Phone (239) 394-8234

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01051974AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Florida Emergency Management LLC Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
Thse - Marco Urgent Care LLC CurrentSince Jul 1, 2017 Accepting new patients
St. Anthony Home Medical Equipment Past Accepting new patients

Locations

40 S Heathwood Dr
Marco Island, FL 34145
Phone (239) 393-4079

15420 Collier Blvd
Naples, FL 34120
Phone (239) 624-0600

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

14050 NW 14th St
Ste 190
Sunrise, FL 33323
Phone (954) 424-3672

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871643791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 POTOMAC CT",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341204474",
            "telephone_number": "239-352-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W HOMER ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463604358",
            "telephone_number": "219-877-1616",
            "fax_number": "219-877-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "PATRICIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01051974A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.