Active NPI
Andrew Ellis Gardner, MD
- Internal Medicine Physician
- Spokane Valley, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 61395632
- Practice address
- 15812 E Indiana Ave
Spokane Valley, WA 99216-1875 - Phone
- (509) 444-8200
- NPI assigned
- Mar 25, 2016
- Last updated
- Jun 22, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | M-14830 | ID | |
| Internal Medicine Physician | 207R00000X | 61395632 | WA | Primary |
Addresses
Primary practice location
15812 E Indiana Ave
Spokane Valley, WA 99216-1875
Mailing address
15812 E Indiana Ave
Spokane Valley, WA 99216-1875
Phone (509) 444-8200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Michigan Medical School, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1001 W 2ND Ave
Spokane, WA 99201-4503
Phone (509) 835-1206
15812 E Indiana Ave
Spokane Valley, WA 99216-1875
Phone (509) 444-8200
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-14830 | ID | MD | Internal Medicine Physician |
| 61395632 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Benewah Medical Center | Current | Accepting new patients | |
| Community Health Association of Spokane | Current | Accepting new patients | |
| Community Health Association of Spokane | Current | Accepting new patients | |
| Community Health Association of Spokane | Current | Accepting new patients |
Locations
427 12th St
Plummer, ID 83851
Phone (208) 686-5081
1720 2nd St
Cheney, WA 99004
Phone (509) 444-8202
914 W Carlisle Ave
Spokane, WA 99205
Phone (509) 325-0393
3919 N Maple St
Spokane, WA 99205
Phone (509) 326-6900
1001 W 2nd Ave
Spokane, WA 99201
Phone (509) 835-1205
611 N Iron Bridge Way
Spokane, WA 99202
5901 N Lidgerwood St
Ste 126
Spokane, WA 99208
Phone (509) 434-1990
5921 N Market St
Spokane, WA 99208
Phone (509) 487-1604
5620 S Regal St
Ste 11
Spokane, WA 99223
Phone (509) 340-1590
15812 E Indiana Ave
Spokane Valley, WA 99216
1502 N Vercler Rd
Spokane Valley, WA 99216
Phone (509) 444-8204
Interoperability endpoints
- andrew.gardner.1@11411.direct.athenahealth.com
Organizations & group practices 4
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.
-
- Federally Qualified Health Center (FQHC)
- Spokane, WA
- NPI 1326005851
-
dba Marimn Health
- Federally Qualified Health Center (FQHC)
- Plummer, ID
- NPI 1336135136
-
- Federally Qualified Health Center (FQHC)
- Spokane Valley, WA
- NPI 1437526456
-
- Federally Qualified Health Center (FQHC)
- Spokane, WA
- NPI 1679363592
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687392000000",
"number": "1902268238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15812 E INDIANA AVE",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992161875",
"telephone_number": "509-444-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15812 E INDIANA AVE",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992161875",
"telephone_number": "509-444-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "ANDREW",
"middle_name": "ELLIS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-25",
"last_updated": "2023-06-22",
"certification_date": "2023-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "ID",
"license": "M-14830",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "61395632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Spokane Valley, WA
- Gardens on University - Spokane Valley LLC
- Gardens on University - Spokane Valley, LLC (Aurora Valley Care)
- Gardens on University- Spokane Valley, LLC (The Gardens on University)
- Colleen Gardiner, DC
- Alyson Gardner, LMP
- Genifer Gardner, RN
- Jessica A Gardner, ATC
- Alyssa Garrett, LMP
- Kathryn Garrison, ARNP
- Terry Lynn Garvin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.