Jaime Renee Gardner, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

08646 Issued in OH

Practice address

205 W Crawford St
Van Wert, OH 45891-1903

Phone

(418) 238-1761

Fax

(418) 238-5055

NPI assigned

Oct 24, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lifelinks Community School

  • Local Education Agency (LEA)
  • Van Wert, OH
  • NPI 1750690202
  NPD (past)
• Van Wert City Schools

  • Local Education Agency (LEA)
  • Van Wert, OH
  • NPI 1003940776
  NPD (past)

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1902201601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ROSEMONT DR",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458912639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W CRAWFORD ST",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458911903",
            "telephone_number": "418-238-1761",
            "fax_number": "418-238-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JAIME",
        "middle_name": "RENEE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "08646",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06004856A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark D Fuerst, D.C.
• Janelle L Fuller
• Shelie Darlene Gaerke, RPH
• Ju Gao, M.D.
• Gavin David Gardner, DC
• Rene Garza, DO
• Tina Marie Gaskill
• Gastro-Intestinal Associates, Inc
• Gastro-Intestinal Associates, Inc
• Gastro-Intestinal Associates, Inc.

• Physical Therapy Assistant in Van Wert, OH
• Providers in Van Wert, OH by specialty
• Physical Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.