CASEY J GARDNER (NPI# 1629059878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629059878 |
Entity Type | Individual |
Full Name | CASEY J GARDNER |
Credential | P.A.C. |
Practice Address |
714 N Senate Ave Ste 100 Indianapolis IN 46202-3763 |
Mailing Address |
4711 N Kenwood Ave Indianapolis IN 46208-3529 |
Practice Telephone | 3174724265 |
Mailing Telephone | 2604138875 |
Enumeration Date | 2005-11-07 |
Last Update Date | 2014-02-04 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
10000672A | IN | Physician Assistants & Advanced Practice Nursing Providers |
N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
10000672A | IN | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | ANTHEM BCBS | 000000643669 | 01 |
IN | MEDICARE PTAN NUMBER | 151020TTTT | 01 |
IN | RAILROAD MEDICARE PTAN NUMBER | P00841261 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528418506 | Casey Gardner | Dental Hygienist | 2441 21st St, Fort Campbell, KY 42223-5582 | 2016-06-21 |
1215150966 | Casey Kimzey Gardner | Pharmacist | 1110 Navaho Dr, Suite 400, Raleigh, NC 27609-7352 | 2007-04-11 |
Street Address |
714 N SENATE AVE STE 100 |
City | INDIANAPOLIS |
State | IN |
Zip Code | 46202-3763 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376546770 | Margaret A Hollar | Radiology | 714 N Senate Ave, Ste Ef100, Indianapolis, IN 46202-3763 | 2005-05-31 |
1497361554 | Jennifer Nicole Nattam | Nurse Practitioner | 714 N Senate Ave, Indianapolis, IN 46202-3763 | 2020-09-23 |
1316487507 | Cayla Sciscoe | Nurse Practitioner | 714 N Senate Ave, Suite 100, Indianapolis, IN 46202-3763 | 2017-03-07 |
1891186763 | Michael D Bortone | Radiology Practitioner Assistant | 714 N Senate Ave, Suite 100, Indianapolis, IN 46202-3763 | 2015-02-12 |
1982039244 | Lindsey D Robertson | Physician Assistant | 714 N Senate Ave, Suite 100, Indianapolis, IN 46202-3763 | 2013-09-05 |
1093098295 | Shawn M Stout | Physician Assistant | 714 N Senate Ave, Ste 120, Indianapolis, IN 46202-3297 | 2011-09-23 |
1457659930 | Yuzhu Tang | Internal Medicine | 714 N Senate Ave, Ste 120, Indianapolis, IN 46202-3297 | 2011-03-07 |
1801109731 | Tyler Rummel | Radiology | 714 N Senate Ave, Suite 100, Indianapolis, IN 46202-3763 | 2010-07-20 |
1346565371 | Stephanie Marie Stahl | Psychiatry & Neurology | 714 N Senate Ave, Suite 120, Indianapolis, IN 46202-3763 | 2010-04-01 |
1952639841 | Heather L Beaty | Physician Assistant | 714 N Senate Ave, Suite 100, Indianapolis, IN 46202-3763 | 2009-12-03 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790386886 | Sara Brooke Horn | Registered Nurse | 1801 N Senate Ave Ste 3300, Indianapolis, IN 46202 | 2020-11-04 |
1013521905 | Zachary Camden Grimes | Registered Nurse | 720 Eskenazi Avenute, Indianapolis, IN 46202 | 2020-09-08 |
1790314045 | Scott C Mitchell II | Student in an Organized Health Care Education/Training Program | Indiana University School of Medicine Dept of Neurosurg, 355 W. 16th St, Gh 5100, Indianapolis, IN 46202 | 2020-04-07 |
1053940676 | James Patrick Kelly Iv | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Dr., Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
1124657697 | Betsy Wilson Stevens | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Drive, Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
1093340580 | Brian T Edmonds | Social Worker | Sandra Eskenazi Mental Health Center, 1700 N Illinois St, Indianapolis, IN 46202 | 2020-03-05 |
1326683210 | Lindsay Nicole Rich | Nurse Practitioner | 1800 N Senate Ave, Indianapolis, IN 46202 | 2019-11-14 |
1427693670 | Ronald Mcdonald House Charities of Central Indiana | Voluntary or Charitable | 435 Limestone Street, Indianaplois, IN 46202 | 2019-11-12 |
1790344760 | Kirsten Denise Leaberry | Student in an Organized Health Care Education/Training Program | Iu Health Neuroscience Center, Goodman Hall, 355 West 16th Street, Indianapolis, IN 46202 | 2019-06-12 |
1679138093 | Chris Olson Jr. | Student in an Organized Health Care Education/Training Program | 1701 N. Senate Blvd, Ag012, Indianapolis, IN 46202 | 2019-05-02 |
Find all providers in zip 46202 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124634936 | Brilyn Michelle Banister | Physician Assistant | 8443 Cabin Creek Dr Apt G, Indianapolis, IN 46237-6330 | 2020-09-17 |
1386290625 | Douglas R Day | Physician Assistant | 1701 N Senate Blvd # Ag373a, Indianapolis, IN 46202-1239 | 2019-08-13 |
1841851409 | Rachel Jagrowski | Physician Assistant | 1801 N Senate Blvd Ste 700, Indianapolis, IN 46202-1177 | 2019-06-25 |
1407311814 | William Peter Thompson | Physician Assistant | 1801 N Capitol Ave # Npe120, Indianapolis, IN 46202-1217 | 2019-02-11 |
1912492679 | Katherine Barrett Tenbarge | Physician Assistant | 1800 N Capitol Ave # E140, Indianapolis, IN 46202-1218 | 2018-06-26 |
1154843704 | Jennifer Trapuzzano | Physician Assistant | 1801 N Senate Blvd Ste 310, Indianapolis, IN 46202-1196 | 2017-07-14 |
1154879666 | Grace Schultz | Physician Assistant | 1408 Broadway St Apt F, Indianapolis, IN 46202-2744 | 2016-09-13 |
1477925071 | Samantha Kitcoff | Physician Assistant | 8180 Clearvista Pkwy Ste 100, Indianapolis, IN 46256 | 2015-10-22 |
1386040046 | Maham Mushtaq | Physician Assistant | 5759 James Blair Dr, Indianapolis, IN 46234-3226 | 2014-11-07 |
1285030924 | Margaret Anne Voelker-park | Physician Assistant | 550 University Blvd Unit 3240, Indianapolis, IN 46202-5250 | 2014-11-07 |
Find all providers in INDIANAPOLIS |
City | INDIANAPOLIS |
Zip Code | 46202 |
Please comment or provide details below to improve the information on CASEY J GARDNER.
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.