NPIMap

Individual provider Active NPI

Charles William Gardner Jr., M.D.

  • Family Medicine Physician
  • Alexandria, VA
National Provider Identifier
1881763670
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101033882 Issued in VA
Practice address
4401 Ford Ave
Suite 250
Alexandria, VA 22302-1473
Phone
(703) 647-4962
Fax
(703) 379-5380
NPI assigned
Nov 7, 2006
Last updated
Jul 7, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101033882 VA Primary

Addresses

Primary practice location

4401 Ford Ave
Suite 250
Alexandria, VA 22302-1473

Mailing address

4401 Ford Ave
Suite 250
Alexandria, VA 22302-1473
Phone (703) 647-4962

Other identifiers 1

IdentifierTypeStateIssuer
P00126329OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110714000359 DC Practitioner - Family Practice 2163690306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northern Virginia Family Practice AssociatesGroup PAC ID 6800872433, 11 clinicians

Practice addresses (Care Compare)

2311 M St NW
Suite 301
Washington, DC 20037-1468
Phone (202) 861-0111

2445 Army Navy Dr
Suite 400
Arlington, VA 22206-2988
Phone (703) 379-8879

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
19.74 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
65.8

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Virginia Family Practice Associates Family Medicine CurrentSince Mar 18, 1987 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2311 M St NW
Ste 301
Washington, DC 20037
Phone (202) 429-3783

2445 Army Navy Dr
Ste 400
Arlington, VA 22206
Phone (703) 379-8879

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1881763670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 FORD AVE",
            "address_2": "SUITE 250",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021473",
            "telephone_number": "703-647-4962",
            "fax_number": "703-379-5380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 FORD AVE",
            "address_2": "SUITE 250",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021473",
            "telephone_number": "703-647-4962",
            "fax_number": "703-379-5380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "CHARLES",
        "middle_name": "WILLIAM",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101033882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00126329",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.