ROBERT WILLIAM GARDNER (NPI# 1023183829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023183829 |
| Entity Type | Individual |
| Full Name | ROBERT WILLIAM GARDNER |
| Practice Address |
6300 E. Hwy 20 Lucerne CA 95458 |
| Mailing Address |
10458 Chatten Court Clearlake Oaks CA 95423-7050 |
| Practice Telephone | 7072749299 |
| Practice Fax Number | 7072749297 |
| Mailing Telephone | 7072749299 |
| Mailing Fax Number | 7072749297 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2012-11-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
G30366 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G303660 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073001897 | Robert Andrew Gardner | Student in an Organized Health Care Education/Training Program | 230 Macnider Hall, 333 South Columbia Street, Chapel Hill, NC 27515 | 2018-04-26 |
| 1649720921 | Robert Gardner | Nutritionist | 645 Industrial Rd, Carlstadt, NJ 07072-1611 | 2016-10-10 |
| 1790040061 | Robert Gardner II | Counselor | 3251 W 85th Pl, 10336 South Western Ave, Chicago, IL 60652-3756 | 2012-07-11 |
| 1023325875 | Robert Ball Gardner | Audiologist | 6475 Wall St Ste 203, Colorado Springs, CO 80918-8341 | 2010-08-31 |
| 1083839302 | Robert B Gardner | Dentist | 9878 W Belleview Ave, Littleton, CO 80123-2101 | 2007-04-13 |
| 1023179850 | Robert S. Gardner | Internal Medicine | 525 College Ave, 211, Santa Rosa, CA 95404-4118 | 2006-12-13 |
| 1740375443 | Robert W Gardner | Family Medicine | 3150 Rogers Rd, Suite 101, Wake Forest, NC 27587-4195 | 2006-10-04 |
| 1295839470 | Robert William Gardner | Dentist | 4490 Indianola Ave., Columbus, OH 43214 | 2006-09-11 |
| 1346251436 | Robert E Gardner | Psychiatry & Neurology | 3250 Gordonville Rd Ste 450, Cape Girardeau, MO 63703-5031 | 2006-08-11 |
| 1932137387 | Robert Edward Gardner | Dentist | 1121 W Main St, Walnut Ridge, AR 72476-1000 | 2006-06-28 |
| Street Address |
6300 E. HWY 20 |
| City | LUCERNE |
| State | CA |
| Zip Code | 95458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649243437 | Joseph Geare | Physician Assistant | 6300 E. Hwy 20, Lucerne, CA 95458 | 2006-02-10 |
| 1437652385 | Jennifer Sue Nauert | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458-9545 | 2018-03-16 |
| 1285963413 | Dr. Gardner Outpatient Program | Community/Behavioral Health | 6300 E. Hwy 20, Lucerne, CA 95458 | 2009-12-17 |
| 1023345857 | Robert W. Gardner Psg-dr. Gardner Outpatient Program | Community/Behavioral Health | 6300 E. Hwy 20, Lucerne, CA 95458 | 2009-11-16 |
| 1194969113 | Lori Carter-runyon | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458 | 2009-04-21 |
| 1235311630 | Elliott Bennett | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458 | 2007-11-28 |
| 1598958076 | Steve Mueller | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458 | 2007-08-20 |
| 1841401825 | Dennis Mason | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458 | 2007-05-24 |
| 1437360492 | Maureen Conway | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458 | 2007-05-24 |
| 1669680120 | James Wilkie | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458 | 2007-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619527512 | Shawna Dee Theodorou | Case Manager/Care Coordinator | 6302 Thirteeth Ave, Lucerne, CA 95458 | 2019-09-13 |
| 1093274508 | Adventist Health Clearlake Hospital, Inc | Clinic/Center | 6300 E. Highway 20, Lucerne, CA 95458 | 2019-03-14 |
| 1750848396 | Catherine Denise Miller | Case Manager/Care Coordinator | 6302 13 Th Ave, Lucerne, CA 95458 | 2019-03-01 |
| 1043774193 | Priest Martinez | Counselor | 6300 E Hwy 20 Unit B, Lucerne, CA 95458 | 2019-01-23 |
| 1700308962 | Joao Adeles Barta | Case Manager/Care Coordinator | 6302 Thirteenth Av., Lucerne, CA 95458 | 2017-07-10 |
| 1154872737 | Deborah Annette Schmidt | Licensed Vocational Nurse | 6302 13th Ave., Lucerne, CA 95458 | 2016-10-19 |
| 1922496199 | Pearlina Drummond | Counselor | 3937 Foothill Drive, Lucerne, CA 95458 | 2014-12-22 |
| 1467881672 | Lucerne Elementary | Local Education Agency (LEA) | 3351 Country Club Drive, Lucerne, CA 95458 | 2013-11-07 |
| 1003245960 | Hilltop Recovery Services | Substance Abuse Rehabilitation Facility | 3937 Foothill Dr, Lucerne, CA 95458 | 2013-11-01 |
| 1053618652 | Chris Partida | Counselor | 6302 13th Ave, Lucerne, CA 95458 | 2011-02-16 |
| Find all providers in zip 95458 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
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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.