KELLY ROBERT GARDNER (NPI# 1255319463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255319463 |
Entity Type | Individual |
Full Name | KELLY ROBERT GARDNER |
Credential | M.D. |
Practice Address |
3061 S Maryland Pkwy Suite 102 Las Vegas NV 89109-2298 |
Mailing Address |
1 Independence Pt Ste 202 Greenville SC 29615-4536 |
Practice Telephone | 7027312888 |
Practice Fax Number | 7026969289 |
Mailing Telephone | 8774062916 |
Enumeration Date | 2006-01-06 |
Last Update Date | 2012-12-28 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
6324 | NV | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NV | 200290213 | 05 | |
NV | BLUE | NV1309 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881071694 | Kelly Crews Gardner | Physical Therapy Assistant | 53 Addie Way, Lynchburg, VA 24501-7255 | 2015-04-30 |
1245420520 | Kelly Holloman Gardner | Counselor | 7165 Getwell Rd Bldg G, Southaven, MS 38672-9619 | 2007-08-01 |
1003325051 | Kelly Ann Gardner | Nurse Practitioner | 600 Highland Ave, Madison, WI 53792 | 2017-09-21 |
1437562618 | Kelly J Gardner | Pediatrics | Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114 | 2014-06-05 |
1629315239 | Kelly Gardner | Physician Assistant | 13207 Ravenna Rd, Chardon, OH 44024-7032 | 2013-01-16 |
1821333659 | Kelly Shannon Gardner | Registered Nurse | 455 Saint Michaels Dr, Santa Fe, NM 87505-7601 | 2012-12-05 |
1558623439 | Kelly Martin Gardner | Registered Nurse | 1035 Creswell Ave, Shreveport, LA 71101-3917 | 2012-06-15 |
1164716593 | Kelly Ann Gardner | Anesthesiology | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2011-06-02 |
1295757524 | Kelly Frances Gardner | Speech-Language Pathologist | 200 Somerset St, Millinocket, ME 04462-1258 | 2006-07-24 |
Street Address |
3061 S MARYLAND PKWY SUITE 102 |
City | LAS VEGAS |
State | NV |
Zip Code | 89109-2298 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053394148 | Larry F Cohler | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3061 S Maryland Pkwy, Suite 202, Las Vegas, NV 89109-2298 | 2005-11-22 |
1396365193 | Jill Vanlandghen | Chiropractor | 3061 S Maryland Pkwy, Las Vegas, NV 89109-2298 | 2020-04-21 |
1356731640 | Christina Paige Steiner | Respiratory Therapist, Registered | 3061 S Maryland Pkwy, Las Vegas, NV 89109-2298 | 2015-01-26 |
1700292513 | William Smith, LLC | Neurological Surgery | 3061 S Maryland Pkwy, Suite 200, Las Vegas, NV 89109-2298 | 2014-07-01 |
1053670190 | Veronica Marie Ibarra | Nurse Practitioner | 3061 S Maryland Pkwy, #101, Las Vegas, NV 89109-2298 | 2012-05-10 |
1013292481 | Dustin D Van Orman | Physician Assistant | 3061 S Maryland Pkwy, Suite 200, Las Vegas, NV 89109-2298 | 2011-10-18 |
1295023885 | Dianne Joyce Capili Yusi | Pediatrics | 3061 S Maryland Pkwy, Suite 101, Las Vegas, NV 89109-2298 | 2011-07-15 |
1902111792 | Ryan Fred Simons | Physician Assistant | 3061 S Maryland Pkwy, Suite 200, Las Vegas, NV 89109-2298 | 2010-08-17 |
1568609881 | The Medical Clinic, Pa | Specialist | 3061 S Maryland Pkwy, Suite 202, Las Vegas, NV 89109-2298 | 2009-01-08 |
1336396258 | Kristin M Hamilton | Physician Assistant | 3061 S Maryland Pkwy, Suite 200, Las Vegas, NV 89109-6227 | 2008-08-21 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942820816 | Vivian Latoza Villasfer | Technician | 2770 South Maryland Parkway, Suite 205b, Las Vegas, NV 89109 | 2020-04-21 |
1235758236 | Happy Life Home Health Services Inc | Chore Provider | 2770 S Maryland Pkwy Suite 205-b, Las Vegas, NV 89109 | 2020-04-10 |
1346890662 | Jaylin Armour | Technician | 2770 S Maryland Pkwy Suite 108b Las Vegas, Nv 89109, Las Vegas, NV 89109 | 2019-09-18 |
1104475003 | Jasmine Thomas | Technician | 2770 S Maryland Pkwy Suite 108 B-g Las Vegas, Nv 89109, Las Vegas, NV 89109 | 2019-09-04 |
1982258331 | Melanee Gregory | Technician | 2770 S Maryland Okey Suite 108b, Suite 108b, Las Vegas, NV 89109 | 2019-07-24 |
1851877583 | Eric Darnell Thompson Jr. | Community/Behavioral Health | 2556 Shrewood Street, Unit 21, Las Vegas, NV 89109 | 2018-07-16 |
1144717117 | Emerging Vision Inc | Technician/Technologist | Mirage Hotel, 3400 Las Vegas Blvd S, Mirage Hotel, Las Vegas, NV 89109 | 2018-04-16 |
1013404110 | Emerging Vision Inc | Technician/Technologist | Mandalay Bay Resort (lobby), 3950 Las Vegas Blvd S, Mandalay Bay Resort (lobby), Las Vegas, NV 89109 | 2018-04-16 |
1750881736 | Amirelys Hernandez Diaz | Technician | 2770 S. Maryland Pkwy, Ste 108b-g, Las Vegas, NV 89109 | 2018-02-16 |
1972036663 | Ashley Murray | Registered Nurse | 2700 S Las Vegas Blvd #1506, Las Vegas, NV 89109 | 2017-04-10 |
Find all providers in zip 89109 |
Taxonomy Code | 2085R0204X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Vascular & Interventional Radiology |
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346312642 | Axiom Imaging of Las Vegas LLC | Radiology | 6460 Medical Center St, Ste. 150, Las Vegas, NV 89148-2406 | 2006-11-14 |
1265894208 | He Xu | Radiology | 9260 W Sunset Rd Ste 201, Las Vegas, NV 89148-4903 | 2016-03-28 |
1740623818 | Mark Barnett Johnson | Radiology | 2020 Palomino Ln Ste 100, Las Vegas, NV 89106-4894 | 2013-04-09 |
1407834435 | Peter L Weidenfeld | Radiology | 3061 S Maryland Pkwy, Suite 102, Las Vegas, NV 89109-2298 | 2006-01-09 |
1366420556 | Steven Henry Davis | Radiology | 3061 S Maryland Pkwy, Suite 102, Las Vegas, NV 89109-2298 | 2006-01-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528589934 | Omnivas Las Vegas LLC | Radiology | 3175 Saint Rose Pkwy Ste 121, Henderson, NV 89052-3507 | 2017-07-06 |
1891907085 | Nadeer Pirani | Radiology | 1905 Mcdaniel St Ste 106, North Las Vegas, NV 89030-7170 | 2007-05-03 |
1548363070 | Ralph Tinghan Ho | Radiology | 59 Damonte Ranch Pkwy Ste B104, Reno, NV 89521-1907 | 2006-09-07 |
1891271581 | Vih Zeetser Pllc | Radiology | 375 N Stephanie St Ste 1011, Henderson, NV 89014-8901 | 2018-07-16 |
1619266632 | Erik J. Maki | Radiology | 2874 N Carson St Ste 300, Carson City, NV 89706-1683 | 2011-03-30 |
1467472324 | Thomas Barcia | Radiology | 1000 Locust St, Reno, NV 89502-2597 | 2006-07-20 |
1699763508 | Eric Lawrence Goldberg | Radiology | 6490 S Mccarran Blvd, Ste 22, Reno, NV 89509-6102 | 2005-10-13 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.