Active NPI
Karen Gardiner
- Intellectual & Developmental Disabilities Psychologist
- Chesapeake, VA
National Provider Identifier
1932869179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual & Developmental Disabilities Psychologist
- License
- 3883
- Practice address
- 1304 Links CT
Chesapeake, VA 23320-9450 - Phone
- (757) 292-7612
- Fax
- (757) 548-6003
- NPI assigned
- Dec 29, 2021
- Last updated
- Dec 29, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 3883 | VA | Primary |
Addresses
Primary practice location
1304 Links CT
Chesapeake, VA 23320-9450
Mailing address
1304 Links CT
Chesapeake, VA 23320-9450
Phone (757) 292-7612
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3883 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3883 | VA | MD | Intellectual & Developmental Disabilities Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1640736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640736000000",
"number": "1932869179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1304 LINKS CT",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233209450",
"telephone_number": "757-292-7612",
"fax_number": "757-548-6003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 LINKS CT",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233209450",
"telephone_number": "757-292-7612",
"fax_number": "757-548-6003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDINER",
"first_name": "KAREN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-29",
"last_updated": "2021-12-29",
"certification_date": "2021-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "VA",
"license": "3883",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3883",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.