Individual provider Active NPI

Todd Gardner

  • Pediatrics Physician
  • Gilbert, AZ
National Provider Identifier
1982124194
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
008462 Issued in AZ
Practice address
2550 E Guadalupe Rd
Gilbert, AZ 85234-5114
Phone
(602) 933-4395
Fax
(602) 933-8958
NPI assigned
Jun 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 008462 AZ Primary

Addresses

Primary practice location

2550 E Guadalupe Rd
Gilbert, AZ 85234-5114

Mailing address

3200 E Camelback Rd Ste 250
Phoenix, AZ 85018-2327
Phone (602) 933-1814

Other practice location 1

2550 E Guadalupe Rd Ste 115
Gilbert, AZ 85234-5114
Phone (602) 933-4395

Other practice location 2

982185 Nebraska Medical Ctr
Omaha, NE 68198-2185
Phone (402) 559-5380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200730000990 AZ Practitioner - Pediatric Medicine 1355615832 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Jul 1, 2020 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jul 1, 2020 Accepting new patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients
Nebraska Medical Center Past Accepting new patients

Locations

60 S Kyrene Rd
Ste 1
Chandler, AZ 85226
Phone (480) 785-8700

1546 N Parkway Dr
Ste 101
Gilbert, AZ 85234
Phone (480) 644-1466

3592 S Atherton Blvd
Ste 101
Gilbert, AZ 85297
Phone (480) 269-0786

2550 E Guadalupe Rd
Ste 115
Gilbert, AZ 85234
Phone (480) 214-2300

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

6301 S McClintock Dr
Ste 101
Tempe, AZ 85283
Phone (480) 214-2300

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1982124194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327",
            "telephone_number": "602-933-1814",
            "fax_number": "602-933-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 E GUADALUPE RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852345114",
            "telephone_number": "602-933-4395",
            "fax_number": "602-933-8958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 E Guadalupe Rd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852345114",
            "country_code": "US",
            "telephone_number": "602-933-4395",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "982185 Nebraska Medical Ctr",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681982185",
            "country_code": "US",
            "telephone_number": "402-559-5380",
            "fax_number": "402-559-5137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "TODD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2022-07-21",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "008462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.