NPIMap

Individual provider Active NPI

Raymond John Gardner, M.D.

  • Family Medicine Physician
  • Marion, OH
National Provider Identifier
1932107489
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-045970 Issued in OH
Practice address
1069 Delaware Ave
Suite 200
Marion, OH 43302-1400
Phone
(740) 223-3496
NPI assigned
Jul 8, 2005
Last updated
Jan 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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 35-045970 OH Primary

Addresses

Primary practice location

1069 Delaware Ave
Suite 200
Marion, OH 43302-1400

Mailing address

1069 Delaware Ave
Suite 200
Marion, OH 43302-1400
Phone (740) 223-3496

Other identifiers 1

IdentifierTypeStateIssuer
0497627MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100426000144 OH Practitioner - Family Practice 1052448941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oh Independent Medical Group LLCGroup PAC ID 0648646034, 136 clinicians

Practice addresses (Care Compare)

1069 Delaware Ave
Suite 205a
Marion, OH 43302-6288
Phone (740) 223-3496

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.5 of 100Reported as apm
Quality
71.52
Promoting interoperability
95.57
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-045970OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mansfield Family Practice Family Medicine Current Accepting new patients
Oh Independent Medical Group LLC CurrentSince Oct 1, 2023 Accepting new patients
Oh Independent Medical Group LLC Family Medicine CurrentSince Oct 1, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

7450 Hospital Dr
Ste 4500
Dublin, OH 43016
Phone (614) 566-0166

248 Blymyer Ave
Mansfield, OH 44903
Phone (419) 524-2212

1069 Delaware Ave
Ste 205A
Marion, OH 43302
Phone (740) 223-3496

1069 Delaware Ave
Ste 205B
Marion, OH 43302
Phone (740) 387-4578

444 N Cleveland Ave
Ste 120
Westerville, OH 43082
Phone (614) 818-0300

Interoperability endpoints

  • Direct secure messaging: raymond.gardner.1@26020.direct.athenahealth.com

Organizations & group practices 5

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 8

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1932107489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1069 DELAWARE AVE",
            "address_2": "SUITE 200",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433021400",
            "telephone_number": "740-223-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1069 DELAWARE AVE",
            "address_2": "SUITE 200",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433021400",
            "telephone_number": "740-223-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "RAYMOND",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-045970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0497627",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.