GLENN PIERCE GARDNER (NPI# 1932165321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932165321 |
Entity Type | Individual |
Full Name | GLENN PIERCE GARDNER |
Credential | MD |
Practice Address |
1086 Franklin St Ste 3002 Johnstown PA 15905-4305 |
Mailing Address |
1086 Franklin St Johnstown PA 15905-4305 |
Practice Telephone | 8145349194 |
Practice Fax Number | 8145345847 |
Mailing Telephone | 8144108300 |
Mailing Fax Number | 8144108331 |
Enumeration Date | 2006-04-25 |
Last Update Date | 2016-03-09 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD 60118824 | WA | Allopathic & Osteopathic Physicians |
N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
20050400008 | MO | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | BLUE SHIELD/BLUE CHOICE | 202277 | 01 |
MO | HEALTHLINK | 259599 | 01 |
MO | 206237307 | 05 | |
PA | 001543260 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861483810 | Glenn David Gardner | Internal Medicine | 1324 Valentine St, Melbourne, FL 32901-3128 | 2005-10-31 |
1881647675 | Glenn Gardner | Anesthesiology | 3815 Highland Ave, Downers Grove, IL 60515-1500 | 2006-05-19 |
1982653929 | Glenn C Gardner | Surgery | 7710 Mercy Road, Suite 305, Omaha, NE 68124 | 2006-05-08 |
Street Address |
1086 FRANKLIN ST STE 3002 |
City | JOHNSTOWN |
State | PA |
Zip Code | 15905-4305 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427051440 | Conemaugh Health Initiatives | Anesthesiology | 1086 Franklin St, Ste A401, Johnstown, PA 15905-4305 | 2005-05-23 |
1245838010 | Kristen Chislow | Registered Nurse | 1086 Franklin St, Johnstown, PA 15905-4305 | 2020-10-14 |
1043818032 | Derick Mostoller | Registered Nurse | 1086 Franklin St, Johnstown, PA 15905-4305 | 2020-10-13 |
1891301776 | Karen Richtar | Physician Assistant | 1086 Franklin St, Johnstown, PA 15905-4305 | 2020-09-16 |
1942819149 | Asfand Yar Butt | Internal Medicine | 1086 Franklin St, Johnstown, PA 15905-4305 | 2020-07-24 |
1285243535 | Muhammad Naqvi | Family Medicine | 1086 Franklin St, Johnstown, PA 15905-4305 | 2020-07-23 |
1245849405 | Steven William Davie | Internal Medicine | 1086 Franklin St, Johnstown, PA 15905-4305 | 2020-07-23 |
1871102038 | Shehbaz Ahmad | Internal Medicine | 1086 Franklin St, Johnstown, PA 15905-4305 | 2020-07-23 |
1467061606 | Iyad Aljadba | Internal Medicine | 1086 Franklin St, Johnstown, PA 15905-4305 | 2020-07-23 |
1396353686 | Symaya Hoque | Family Medicine | 1086 Franklin St, Johnstown, PA 15905-4305 | 2020-07-22 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528552445 | Kristina Marie Sloan | Registered Nurse | Womens Center At Memorial Medical Center, 1111 Franklin St, Suite 210, Johnstown, PA 15905 | 2018-06-15 |
1376921403 | Joel Edward Messom | Obstetrics & Gynecology | 1111 Franklin St Ste 300, Johnstown, PA 15905 | 2015-05-08 |
1497091797 | Jessica Pacsai | Occupational Therapist | 807 Goucher Street, Johnstown, PA 15905 | 2012-12-14 |
1225396351 | Lusine Mesropyan | Surgery | 1086 Franklin Street Good Samaritan Building, Johnstown, PA 15905 | 2012-04-26 |
1467766931 | Kimberly Buchanan | Speech-Language Pathologist | 787 Goucher Street, Johnstown, PA 15905 | 2010-07-27 |
1205149846 | Lighthouse Medical, LLC | Clinic/Center | 507 Tire Hill Road, Suite 100, Johnstown, PA 15905 | 2010-07-26 |
1932357878 | Michael Cameron Sleet | Surgery | Dlp Conemaugh Memorial Hospital, 1086 Franklin Street, Johnstown, PA 15905 | 2008-09-04 |
1255528543 | Assisted Living Concepts Inc | Assisted Living Facility | 500 Cheney Oaks Drive, Johnstown, PA 15905 | 2007-10-01 |
1578766648 | Tamera Waggle | Nurse Anesthetist, Certified Registered | 1186 Franklin St., Johnstown, PA 15905 | 2007-06-07 |
1821206178 | Blue and Green Medical PC | Internal Medicine | 1743 Goucher Street, Johnstown, PA 15905 | 2007-05-18 |
Find all providers in zip 15905 |
Taxonomy Code | 2086S0129X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Vascular Surgery |
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679707061 | Conemaugh Health Initiatives | Surgery | 1086 Franklin St, Third Floor, Building M, Room 3002, Johnstown, PA 15905-4305 | 2009-05-13 |
1760591408 | Marty M Salas | Surgery | 970 Franklin Street, Johnstown, PA 15905 | 2006-08-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720630650 | Broad Street Professional Medical Services LLC | Surgery | 2033 S Broad St Ste A, Philadelphia, PA 19148-5505 | 2019-07-11 |
1124670922 | Broad Street Medical LLC | Surgery | 2033 S Broad St Ste B, Philadelphia, PA 19148-5505 | 2019-07-11 |
1932610755 | Vascular Surgical Specialists Pllc | Surgery | 1450 E Boot Rd Ste 600b, West Chester, PA 19380-5968 | 2017-10-19 |
1336515956 | Aria Health Physician Services | Surgery | 9501 Roosevelt Blvd Ste 312, Philadelphia, PA 19114-1028 | 2015-08-18 |
1437525490 | Advanced Vein and Laser Center Lancaster, LLC | Surgery | 896a Plaza Blvd, Lancaster, PA 17601-2745 | 2015-08-13 |
1447658877 | Center for Vein Restoration Pa Pllc | Surgery | 1338 Bristol Pike Ste 205, Bensalem, PA 19020-5679 | 2014-12-17 |
1023423167 | Catherine Go | Surgery | 420 S Aiken Ave, Apt A6, Pittsburgh, PA 15232-1226 | 2014-06-27 |
1659703635 | Walter J. Fagan | Surgery | 211 Center Ave, Jim Thorpe, PA 18229-1205 | 2013-08-01 |
1346521267 | Usa Vein Clinics of Philadelphia LLC | Surgery | 51 Cameron Rd, Huntingdon Valley, PA 19006-1401 | 2011-09-06 |
1124314893 | Nathan Loren Liang | Surgery | 200 Lothrop St # A-1017, Pittsburgh, PA 15213-2536 | 2011-06-21 |
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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.