KELLY GARDINER (NPI# 1447294970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447294970 |
| Entity Type | Individual |
| Full Name | KELLY GARDINER |
| Practice Address |
12871 E Jefferson Ave Detroit MI 48215-2754 |
| Practice Telephone | 3138213900 |
| Practice Fax Number | 3132174590 |
| Mailing Telephone | 3138213900 |
| Mailing Fax Number | 3132174590 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2020-02-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 4704170979 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184237075 | Kelly Ann Gardiner | Dietitian, Registered | 9123 Retablo Rd Nw, Albuquerque, NM 87120-7138 | 2020-08-28 |
| Street Address |
12871 E JEFFERSON AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48215-2754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548252240 | Gloria Chaney | Family Medicine | 12871 E Jefferson Ave, Detroit, MI 48215-2754 | 2005-08-18 |
| 1720619091 | Sunshine Mental Health Care | Nurse Practitioner | 12871 E Jefferson Ave, Detroit, MI 48215-2754 | 2020-01-27 |
| 1730681735 | Kidds Comfort Transportation Services,llc | Driver | 12871 E Jefferson Ave, Detroit, MI 48215-2754 | 2018-03-06 |
| 1154854016 | Lenyie Ngbogbara | Pharmacist | 12871 E Jefferson Ave, Detroit, MI 48215-2754 | 2017-04-07 |
| 1144770652 | Abdul Ghani Fahd Mohammed | Dentist | 12871 E Jefferson Ave, Ste. C, Detroit, MI 48215-2754 | 2016-10-07 |
| 1871617290 | Stephen Thomas Holmes | Dentist | 12871 E Jefferson Ave, Ste C, Detroit, MI 48215-2754 | 2007-03-19 |
| 1710039383 | Baig Dental Group, P.C. | Dentist | 12871 E Jefferson Ave, Ste. C, Detroit, MI 48215-2754 | 2007-01-17 |
| 1437161437 | Park Family Health Care, P.C. | Family Medicine | 12871 E Jefferson Ave, Detroit, MI 48215-2754 | 2006-08-12 |
| 1194770628 | Viraj V Shah | Dentist | 12871 E Jefferson Ave, Ste. C, Detroit, MI 48215-2754 | 2006-05-23 |
| 1801888565 | Richard M. Brown | Family Medicine | 12871 E Jefferson Ave, Detroit, MI 48215-2754 | 2005-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073035473 | Creative Empowerment Counseling Services, LLC | Community/Behavioral Health | 214 Manistique, Detroit, MI 48215 | 2017-07-07 |
| 1801323530 | Tanya Wade | Social Worker | 12800 E Warren, Detroit, MI 48215 | 2017-05-12 |
| 1992164289 | Juanita Johnson | Counselor | 13336-40 E. Warren Ave, Detroit, MI 48215 | 2016-02-16 |
| 1629476379 | Northeast Guidance Center | Community/Behavioral Health | 12800 Warren, Detroit, MI 48215 | 2014-12-11 |
| 1407253412 | Conner Pharmacy LLC | Pharmacy | 4673 Conner Street, Detroit, MI 48215 | 2014-11-20 |
| 1053734285 | Dawne Robinson | Counselor | 2995 Conner St, Detroit, MI 48215 | 2014-01-23 |
| 1790065357 | Michelle Miller | Counselor | 2900 Conner, Bldg. A, Detroit, MI 48215 | 2011-08-26 |
| 1710286836 | Northeast Guidance Center | Community/Behavioral Health | 2900 Conner St, Ste A, Detroit, MI 48215 | 2011-03-16 |
| 1871892992 | Lisa Nicole Marszalec | Counselor | 12800 East Warren Ave, Detroit, MI 48215 | 2011-03-16 |
| 1881845014 | Deborah A Caldwell | Nutritionist | 13340 E Warren, Detroit, MI 48215 | 2008-10-07 |
| Find all providers in zip 48215 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629616511 | Nursing Practice Corporation | Nurse Practitioner | 1550 Taylor St, Detroit, MI 48206-2081 | 2019-12-11 |
| 1578026076 | Julia Christine Zaddock | Nurse Practitioner | 12800 Toronto St., Detroit, MI 48217 | 2019-04-11 |
| 1629552112 | Katelyn E. Hamann | Nurse Practitioner | Children's Hosptial of Mi, 3901 Beaubien - 2nd Fl - Carl's Bldg, Detroit, MI 48201-2119 | 2018-09-20 |
| 1750801023 | Amy Marie Bertha | Nurse Practitioner | New Center One/endocrinology/metabolism, 3031 W. Grand Blvd, Detroit, MI 48202 | 2017-06-27 |
| 1376077107 | Maryam Hakemi | Nurse Practitioner | 3990 John R. St., Harper University Hospital, Detroit, MI 48201 | 2017-04-19 |
| 1841748076 | Jennifer N. Watson | Nurse Practitioner | 3950 Beaubien - Ground Fl, Children's Hospital of Mi, Detroit, MI 48201-2153 | 2016-09-16 |
| 1891164323 | Cheryl Barratt | Nurse Practitioner | Children's Hospital of Mi - Er, 3901 Beaubien, Detroit, MI 48201 | 2015-09-15 |
| 1730556291 | Markita Marie Thompson | Nurse Practitioner | 277 Gratiot Ave Ste 100a8919, Detroit, MI 48226-2239 | 2015-08-31 |
| 1316372980 | Sarah Kironde | Nurse Practitioner | 7700 2nd Avenue, Detroit, MI 48202 | 2013-09-13 |
| 1679917322 | Arlanda Latrice Smith | Nurse Practitioner | 8904 Woodward Ave, Detroit, MI 48202-1821 | 2013-04-24 |
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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.