TIMOTHY L. GARDNER, DPM,PC (NPI# 1225220379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225220379 |
| Entity Type | Organization |
| Organization Name | TIMOTHY L. GARDNER, DPM,PC |
| Other Organization Name | MIDDLESBORO FOOT & ANKLE CLINIC |
| Practice Address |
123 N 19th St Middlesboro KY 40965-2865 |
| Mailing Address |
10810 Parkside Dr Ste 202 Knoxville TN 37934-1981 |
| Practice Telephone | 6062482739 |
| Practice Fax Number | 6062482730 |
| Mailing Telephone | 8652187474 |
| Mailing Fax Number | 8652187475 |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2011-10-17 |
| Authorized Official Name | DR. TIMOTHY LOGAN GARDNER (PODIATRIST) |
| Authorized Official Telephone | 6062482739 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
30924 | KY | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 80002017 | 05 | |
| TN | BCBS | 0191729 | 01 |
| TN | 3351921 | 05 | |
| KY | BCBS | 000000053556 | 01 |
| Other Name | Type Code |
|---|---|
| Middlesboro Foot & Ankle Clinic | Doing Business As Name - Organization |
| Street Address |
123 N 19TH ST |
| City | MIDDLESBORO |
| State | KY |
| Zip Code | 40965-2865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003816372 | Charles A Moore | Internal Medicine | 123 N 19th St, Suite 201, Middlesboro, KY 40965-2865 | 2005-07-28 |
| 1548673155 | Marcinia Michelle Bailey | Nurse Practitioner | 123 N 19th St, Suite A201, Middlesboro, KY 40965-2865 | 2014-06-11 |
| 1699195883 | Aimee Nicole Brock | Nurse Practitioner | 123 N 19th St, Middlesboro, KY 40965-2865 | 2014-04-26 |
| 1083996532 | Lynda Lynn Browning | Nurse Practitioner | 123 N 19th St, Middlesboro, KY 40965-2865 | 2011-09-11 |
| 1659551935 | Charles A Moore | Clinic/Center | 123 N 19th St, Suite 201, Middlesboro, KY 40965-2865 | 2007-11-05 |
| 1396924544 | Bruce T. Wilson,d.m.d., Psc | Dentist | 123 N 19th St, Middlesboro, KY 40965-2865 | 2007-10-24 |
| 1114133055 | Drs Rose and Thomas | Surgery | 123 N 19th St, Middlesboro, KY 40965 | 2007-05-15 |
| 1942250592 | Comprehensive Home Healthcare Services LLC | Case Management | 123 N 19th St, Suite 5, Middlesboro, KY 40965-2865 | 2006-05-12 |
| 1619978327 | Robert Lee Thomas Iv | Surgery | 123 N 19th St, Suite B301, Middlesboro, KY 40965-2865 | 2005-08-03 |
| 1881694271 | Medical Services of America Inc | Emergency Response System Companies | 123 N 19th St, Middlesboro, KY 40965-2865 | 2005-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396387064 | Christopher Bruce Ellison | Social Worker | 809 19th Street, Middlesboro, KY 40965 | 2019-10-14 |
| 1982255030 | Johnny Wade Nantz II | Case Manager/Care Coordinator | 809 N 19th St, Middlesboro, KY 40965 | 2019-09-20 |
| 1558827774 | August Pediatrics, LLC | Pediatrics | 123 N 19th St Ste 302, Middlesboro, KY 40965 | 2019-02-12 |
| 1558843227 | Bethany Lauren Wade | Case Manager/Care Coordinator | 19th St, 809, Middlesboro, KY 40965 | 2018-08-30 |
| 1124521505 | Sonya Joyce Mcneil | Speech-Language Pathologist | Kidabilities Pediatric Therapy Center, 2801 Highway 25e, Suite 98, Middlesboro, KY 40965 | 2018-03-13 |
| 1518499862 | Vikki Lynn Johnson | Case Manager/Care Coordinator | 809 North 19th Street, Middlesboro, KY 40965 | 2017-03-28 |
| 1184164287 | Wilson Jeffrey | Occupational Therapist | Address: 235 New Wilson Lane, Middlesboro, KY 40965 | 2017-03-08 |
| 1447797444 | Lesha Loretta Williams | Physician Assistant | 2004 Cumberland Ave Ste 100, Middlesboro, KY 40965 | 2017-01-27 |
| 1619423910 | Audra Anissa Hall | Physical Therapist | 108 Turner Lane, Middlesboro, KY 40965 | 2016-08-28 |
| 1700332061 | Tammy Mclain | Counselor | Selfrefind 809 North 19th Street, Middlesboro, KY 40965 | 2016-08-28 |
| Find all providers in zip 40965 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821651852 | Sports Medicine Surgical Specialists Pllc | Podiatrist | 309 Guthrie St, Louisville, KY 40202-1813 | 2019-04-16 |
| 1265935977 | Family Podiatry Center Pllc | Podiatrist | 9850 Von Allmen Ct, Louisville, KY 40241 | 2018-03-09 |
| 1811423460 | Jillian Allison Teslow Rickertsen | Podiatrist | 734 W Main St Ste 100, Louisville, KY 40202-3687 | 2017-05-02 |
| 1992239214 | Nathaniel Winters | Podiatrist | 6801 Dixie Hwy Ste 134, Louisville, KY 40258-3952 | 2017-04-13 |
| 1992188437 | Brett P Vessell | Podiatrist | 4119 Browns Ln Ste 2, Louisville, KY 40220-1500 | 2015-07-01 |
| 1295172211 | Alan Kidon | Podiatrist | 1401 Harrodsburg Rd Ste C115, Lexington, KY 40504 | 2013-05-31 |
| 1093085367 | Ann Wolford | Podiatrist | 1850 Westen St, Bowling Green, KY 42104 | 2012-01-04 |
| 1740575653 | Harpreet S Minhas | Podiatrist | 420 Hopkinsville St, Greenville, KY 42345-1102 | 2011-06-20 |
| 1528375821 | Cumberland Foot and Ankle Center | Podiatrist | 49 Medical Loop, Whitley City, KY 42653-0000 | 2010-09-08 |
| 1760798045 | Cumberland Foot and Ankle Center | Podiatrist | 49 Gregory St, Monticello, KY 42633-2407 | 2010-08-25 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLESBORO |
| Zip Code | 40965 |
Please comment or provide details below to improve the information on TIMOTHY L. GARDNER, DPM,PC.
| 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.