CARSON T GARDNER (NPI# 1326005653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326005653 |
| Entity Type | Individual |
| Full Name | CARSON T GARDNER |
| Credential | MD |
| Practice Address |
26246 Crane Rd White Earth MN 56591-9998 |
| Practice Telephone | 2189833286 |
| Mailing Telephone | 2189833286 |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2018-03-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 24990 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICA | 0107998 | 01 | |
| BCBS | 43P02GA | 01 | |
| PREFERRED ONE | 585241029522 | 01 | |
| MN | 160003600 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 40520 Co Hwy 34, White Earth Health Center, Ogema, MN 56569 | 2189834300 | 2189836217 |
| Street Address |
26246 CRANE RD |
| City | WHITE EARTH |
| State | MN |
| Zip Code | 56591-9998 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750999488 | Katie Lynn Hoban | Dietitian, Registered | 26246 Crane Rd, White Earth, MN 56591-9998 | 2020-07-20 |
| 1487161972 | Shannon Mary Jaakola Smith | Marriage & Family Therapist | 26246 Crane Rd, White Earth, MN 56591-9998 | 2018-01-05 |
| 1144752056 | Grant Justin Atwood | Counselor | 26246 Crane Rd, White Earth, MN 56591-9998 | 2017-03-30 |
| 1710422779 | Kristin Petersen | Social Worker | 26246 Crane Rd, White Earth, MN 56591-9998 | 2016-12-30 |
| 1215382320 | Sean Simpson | Social Worker | 26246 Crane Rd, White Earth, MN 56591-9998 | 2016-04-26 |
| 1073972048 | White Earth Band of Ojibwe | Community/Behavioral Health | 26246 Crane Rd, White Earth, MN 56591-9998 | 2016-02-18 |
| 1366832628 | Diane Mcarthur | Dietitian, Registered | 26246 Crane Rd, White Earth, MN 56591-9998 | 2015-01-26 |
| 1174944110 | White Earth Band of Chippewa | Clinic/Center | 26246 Crane Rd, White Earth, MN 56591-9998 | 2013-12-18 |
| 1255617684 | Sarah Jane Jasken | Social Worker | 26246 Crane Rd, White Earth, MN 56591-9998 | 2011-10-31 |
| 1033419163 | Jacinta Rae Putnam | Counselor | 26246 Crane Rd, White Earth, MN 56591 | 2010-10-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033597216 | White Earth Band of Chippewa Indians | Counselor | 35233 Mission Lake Road, White Earth, MN 56591 | 2015-05-08 |
| 1225359722 | Barbara J. Chromy | Counselor | 26246 Crane Road, White Earth Tribal Mental Health, White Earth, MN 56591 | 2010-06-18 |
| 1467600452 | Justin Douglas Mcdonald | Psychologist | White Earth Mental Health, 26246 Crane Rd, White Earth, MN 56591 | 2008-09-03 |
| 1447353883 | White Earth Band of Chippewa | Clinic/Center | 35708 Cty Hwy 21, White Earth, MN 56591 | 2006-09-07 |
| 1578571410 | Willy Ann Heisler | Student in an Organized Health Care Education/Training Program | 36510 County Rd 21, White Earth, MN 56591 | 2006-08-04 |
| 1275908709 | Kandi Burr-fisher | Psychologist | 26246 Crane Road, White Earth, MN 56591 | 2015-12-09 |
| 1003052192 | White Earth Band of Chippewa Indians | Clinic/Center | 36510 County Rd 21, White Earth, MN 56591 | 2008-12-19 |
| 1811169337 | White Earth Tribal Mental Health | Community/Behavioral Health | 35686 County Hwy 21, White Earth, MN 56591-0300 | 2008-03-25 |
| 1881883890 | Angela Marie Bellanger | Social Worker | 35686 County Highway 21, White Earth, MN 56591-0300 | 2007-10-16 |
| 1578715736 | James M. Schmitt | Social Worker | 35686 County Highway 21, White Earth, MN 56591-0300 | 2008-10-21 |
| Find all providers in zip 56591 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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| 1083189203 | Altru Health System | Family Medicine | 23076 347th Street Se, Erskine, MN 56535-9466 | 2018-10-04 |
| 1477039204 | Dollar Clinic Pllc | Family Medicine | 1002 1st Ave N, Moorhead, MN 56560-2003 | 2018-07-16 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| Find all providers with the same taxonomy | ||||
| City | WHITE EARTH |
| Zip Code | 56591 |
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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.