Rjai De Rico Gardner, BA CSS

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

428 24TH Ave N
Columbus, MS 39705-1945

Phone

(662) 241-7097

Fax

(662) 245-0511

NPI assigned

Apr 3, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Rjai De Rico Gardner Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1972035335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 24TH AVE N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397051945",
            "telephone_number": "662-241-7097",
            "fax_number": "662-245-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 24TH AVE N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397051945",
            "telephone_number": "662-241-7097",
            "fax_number": "662-245-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "RJAI",
        "middle_name": "DE RICO",
        "name_prefix": "Mr.",
        "credential": "BA CSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RJAI",
            "last_name": "GARDNER",
            "middle_name": "DE RICO",
            "prefix": "MR.",
            "credential": "BA CSS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Gac Anesthesia, LLC
• Stephanie McLain Gale, APRN
• George Christopher Galjour, MD
• Shaqualar Monique Gandy, NP
• Garden Hill Assisted Living
• Justin M. Garner, M.D.
• Mary Person Garner, M.D.
• Misti Garnett, NP
• James Harvey Garrett Jr., MSPT
• Gastroenterology Associates of Columbus, LLC

• Counselor in Columbus, MS
• Providers in Columbus, MS by specialty
• Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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.