Christopher James Gardner, PA-S, NREMT
Individual provider Active NPI Physician Assistant · Eglin, FL
NPI 1992241582 · NPPES record last updated Jan 6, 2017
Key facts
- NPI
- 1992241582
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 307 Boatner Rd
Eglin, FL 32542-1302 - Phone
- (850) 883-8542
- NPI assigned
- Jan 6, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hospital Medicine Associates LLC
Practice addresses (Care Compare)
25 Wells St
Westerly, RI 02891-2922
Phone (401) 348-3325
365 Montauk Ave
New London, CT 06320-4700
Phone (860) 442-0711
Hospital & facility affiliations
- Westerly Hospital
- Lawrence & Memorial Hospital
- Yale-New Haven Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CT, RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181127002204 | CT | Practitioner - Physician Assistant | 7416291729 | Reassigns benefits to 1 organization |
| I20200813002324 | RI | Practitioner - Physician Assistant | 7416291729 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ipc Hospitalists of New England, P.C. | Physician Assistant | Past | Accepting new patients |
Interoperability endpoints
- cgardner398953@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
307 Boatner Rd
Eglin, FL 32542-1302
Mailing address
307 Boatner Rd
Eglin, FL 32542-1302
Phone (850) 883-8542
Other names
- Chris James Gardner
Other providers in Eglin, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.