MR. JERRY L GARDNER (NPI# 1780611822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780611822 |
| Entity Type | Individual |
| Full Name | MR. JERRY L GARDNER |
| Credential | RPA-C |
| Practice Address |
2125 River Rd Suite 100 Niskayuna NY 12309-1135 |
| Mailing Address |
711 Troy Schenectady Rd Suite 203 Latham NY 12110-2442 |
| Practice Telephone | 5188363030 |
| Practice Fax Number | 5188363020 |
| Mailing Telephone | 5187823700 |
| Mailing Fax Number | 5187823799 |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2014-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 009170 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03810708 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396040838 | Jerry D. Gardner | Family Medicine | 75 Desilva Island Drive, Mill Valley, CA 94941 | 2011-01-13 |
| 1649494311 | Jerry Lee Gardner | Licensed Practical Nurse | 1651 Kendall St, Lakewood, CO 80214-1412 | 2007-04-12 |
| 1750344206 | Jerry Ryan Gardner | Chiropractor | 927 Cox Rd, Gastonia, NC 28054-3455 | 2006-04-07 |
| Street Address |
2125 RIVER RD SUITE 100 |
| City | NISKAYUNA |
| State | NY |
| Zip Code | 12309-1135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861946246 | Jessica Fontanelli | Dietitian, Registered | 2125 River Rd, Suite 302, Niskayuna, NY 12309-1135 | 2016-08-15 |
| 1346668977 | Paula K Pecoraro | Registered Nurse | 2125 River Rd, Suite 302, Niskayuna, NY 12309-1135 | 2014-04-01 |
| 1508205907 | Erin P Adams | Physician Assistant | 2125 River Rd, Suite 302, Niskayuna, NY 12309-1135 | 2013-06-19 |
| 1548605470 | Amanda Jean Hardt | Registered Nurse | 2125 River Rd, Suite 302, Niskayuna, NY 12309-1135 | 2013-05-06 |
| 1922398916 | Jessica Walsh | Physician Assistant | 2125 River Rd, Suite 100, Niskayuna, NY 12309-1135 | 2011-04-12 |
| 1013018829 | Malene Kay Ingram | Surgery | 2125 River Rd, Suite 302, Niskayuna, NY 12309-1135 | 2006-09-26 |
| 1649218538 | Vishnudas Panemanglore Pai | Surgery | 2125 River Rd, Suite 302, Niskayuna, NY 12309-1135 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154973071 | Albany Med Niskayuna Ambulatory Endoscopy and Surgery Center | Clinic/Center | 1769 Union Street, 3rd Floor, Niskayana, NY 12309 | 2019-07-11 |
| 1902396351 | Erica S Hill | Occupational Therapist | 2246 Van Rensselaer Dr, Niskayuna, NY 12309 | 2018-05-11 |
| 1588107015 | Orthopedicsny, LLP | Orthopaedic Surgery | 1760 Union St, Suite 100, Schenectady, NY 12309 | 2016-12-01 |
| 1932589983 | Patricia P Primomo | Dentist | 2310 Nott Street East, Niskayuna, NY 12309 | 2015-06-04 |
| 1386074268 | Bernard P Kinlan | Social Worker | 1 Ascot Lane, Terrace At Glen Eddy, Niskayuna, NY 12309 | 2013-11-14 |
| 1255680344 | Rudy Nydegger Phd, Abpp, Pllc | Psychologist | 2317 Balltown Rd., Suite 203, Schenectady, NY 12309 | 2012-09-05 |
| 1407104094 | Rachelle Ann Kehoe | Specialist | 950 St. David's Lane, Schenectady, NY 12309 | 2012-08-29 |
| 1073882726 | Kristina Lynn Deangelo | Speech-Language Pathologist | 1872 Hexam Road West, Niskayuna, NY 12309 | 2011-12-27 |
| 1467720136 | Jjm Chiropractic, LLC | Chiropractor | 1756 Union St., Niskayuna, NY 12309 | 2011-12-08 |
| 1659658474 | Richard W Glover | Dentist | 2310 Nott St. East, Niskayuna, NY 12309 | 2011-11-08 |
| Find all providers in zip 12309 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598857 | Brittany Christine Androsko | Physician Assistant | 1769 Union St Fl 2, Niskayuna, NY 12309-6311 | 2020-11-05 |
| 1871101501 | Fallon V Etkin | Physician Assistant | 1 Alice Wagner Way Apt 14, Niskayuna, NY 12309-3765 | 2020-07-20 |
| 1790776136 | Jennifer Alison Kresge | Physician Assistant | Belluvue Women's Center, 2210 Troy-schenectady Road, Niskayuna, NY 12309 | 2005-11-03 |
| 1477170967 | Alanna Garcia Miller | Physician Assistant | 1769 Union St, Niskayuna, NY 12309-6311 | 2020-06-30 |
| 1588219265 | Jessica Ma | Physician Assistant | 1769 Union St, Niskayuna, NY 12309-6311 | 2019-08-08 |
| 1508427378 | Michelyn Marie Little | Physician Assistant | 1769 Union St, Niskayuna, NY 12309-6311 | 2019-06-24 |
| 1508205907 | Erin P Adams | Physician Assistant | 2125 River Rd, Suite 302, Niskayuna, NY 12309-1135 | 2013-06-19 |
| 1922398916 | Jessica Walsh | Physician Assistant | 2125 River Rd, Suite 100, Niskayuna, NY 12309-1135 | 2011-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821026 | Victoria Yunaev | Physician Assistant | 7203 166th St, Fresh Meadows, NY 11365-3237 | 2020-11-05 |
| 1164023172 | Betina Charlotte Apostol Nuguid | Physician Assistant | 1730 Central Park Ave Ste 3p, Yonkers, NY 10710-4905 | 2020-11-05 |
| 1023619129 | Anna Leigh Vonck | Physician Assistant | 2 Executive Park Dr Ste 2, Albany, NY 12203-3700 | 2020-11-04 |
| 1952902256 | Billy Phuoctan Truong | Physician Assistant | 8832 18th Ave, Brooklyn, NY 11214-6002 | 2020-11-03 |
| 1205437621 | Jason Patrick Feak | Physician Assistant | 6338 Falls Blvd, Chittenango, NY 13037-8799 | 2020-11-03 |
| 1437750742 | Drew James Mitchell | Physician Assistant | 58 Old Bedford Rd, Goldens Bridge, NY 10526-1000 | 2020-11-03 |
| 1306446125 | Julie Mcphillips | Physician Assistant | 961 W Kaisertown Rd, Montgomery, NY 12549-2317 | 2020-10-30 |
| 1487254330 | Thomas J Nagel | Physician Assistant | 57 Montgomery Road, Fort Montgomery, NY 10922 | 2020-10-29 |
| 1700486560 | Jayanti Rao | Physician Assistant | 1059 Union St Apt 3g, Brooklyn, NY 11225-1268 | 2020-10-29 |
| 1902405772 | Brian Spies | Physician Assistant | 5801 Sutton Dr, Cicero, NY 13039-9546 | 2020-10-22 |
| Find all providers with the same taxonomy | ||||
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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.