Individual provider Active NPI

Nancy Jean Gardner, LP, LPC

  • Psychologist
  • Bay City, MI
National Provider Identifier
1871723577
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
2355 Delta Rd
Bay City, MI 48706-9340
Phone
(989) 684-6832
NPI assigned
Jul 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401007086 MI
Psychologist 103T00000X Primary

Addresses

Primary practice location

2355 Delta Rd
Bay City, MI 48706-9340

Mailing address

2355 Delta Rd
Bay City, MI 48706-9340
Phone (989) 684-6832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140613001572 MI Practitioner - Clinical Psychologist 4385868314 Reassigns benefits to 2 organizations
Practice locations: Bay City, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

863 N Pine Rd
Suite C
Essexville, MI 48732-2159
Phone (989) 778-2272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401007086MIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Directions Counseling and Neurobehavioral Center, LLC CurrentSince Sep 1, 2017 Accepting new patients
Planning for Living Associates Inc CurrentSince May 8, 2014 Accepting new patients

Locations

2355 Delta Rd
Bay City, MI 48706
Phone (989) 667-5654

2711 Center Ave
Ste 109
Essexville, MI 48732
Phone (989) 545-0112

863 N Pine Rd
Ste C
Essexville, MI 48732
Phone (989) 778-2272

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1871723577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 DELTA RD",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487069340",
            "telephone_number": "989-684-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 DELTA RD",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487069340",
            "telephone_number": "989-684-6832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "NANCY",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "LP, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401007086",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

Verify at the official NPI Registry.