Individual provider Active NPI

Emily Gardner

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1881271716
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A192325 Issued in CA
Practice address
757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone
(310) 267-9132
NPI assigned
Mar 26, 2021
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A192325 CA Primary

Addresses

Primary practice location

757 Westwood PLZ
Los Angeles, CA 90095-8358

Mailing address

757 Westwood Plaza Box 951752, 3108 Rrumc
Los Angeles, CA 90095-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240627003848 CA Practitioner - Pediatric Medicine 2466996715 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A192325CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Jun 17, 2024 Accepting new patients

Locations

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

4650 W Sunset Blvd
#87
Los Angeles, CA 90027

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: emily.gardner.1@29189.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1881271716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLAZA BOX 951752, 3108 RRUMC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958358",
            "telephone_number": "310-267-9132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "EMILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A192325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.