Individual provider Active NPI

Karen Gardiner

  • Intellectual & Developmental Disabilities Psychologist
  • Chesapeake, VA
National Provider Identifier
1932869179
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
License
3883 Issued in VA
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, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3883MedicaidVA

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

LicenseStateTypeSpecialty
3883VAMDIntellectual & 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.

Verify at the official NPI Registry.