Active NPI
Ross A Gardner, D.C.
- Chiropractor
- Vero Beach, FL
National Provider Identifier
1972970648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 11787
- Practice address
- 333 17TH St
Ste N
Vero Beach, FL 32960-5686 - Phone
- (772) 563-2900
- Fax
- (772) 563-2961
- NPI assigned
- Aug 28, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 012691 | NY | |
| Chiropractor | 111N00000X | 11787 | FL | Primary |
Addresses
Primary practice location
333 17TH St
Ste N
Vero Beach, FL 32960-5686
Mailing address
333 17TH St
Ste N
Vero Beach, FL 32960-5686
Phone (772) 563-2900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160415000001 | FL | Practitioner - Chiropractic | 9739487331 | Practice locations: Vero Beach, FL |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- New York Chiropractic College, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
777 37TH St
Suite B107
Vero Beach, FL 32960-7301
Phone (772) 563-2900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012691 | NY | MD | Mental Health Counselor |
| 11787 | FL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kenneth Gilmore DC PA | Chiropractor | Past | Accepting new patients |
| Beachside Detox LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- NPI 1598272098
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- Chiropractor
- Fort Pierce, FL
- NPI 1619150901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592265600000",
"number": "1972970648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 17TH ST",
"address_2": "STE N",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329605686",
"telephone_number": "772-563-2900",
"fax_number": "772-563-2961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 17TH ST",
"address_2": "STE N",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329605686",
"telephone_number": "772-563-2900",
"fax_number": "772-563-2961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "ROSS",
"middle_name": "A",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-28",
"last_updated": "2020-06-16",
"certification_date": "2020-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "012691",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "11787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vero Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.