CHARLES JACOB GARDNER (NPI# 1902316946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902316946 |
| Entity Type | Individual |
| Full Name | CHARLES JACOB GARDNER |
| Credential | PA-C |
| Practice Address |
1600 S 20th Ave Safford AZ 85546-4011 |
| Mailing Address |
2625 S Montierth Ln Safford AZ 85546-9418 |
| Practice Telephone | 9283484000 |
| Mailing Telephone | 9287923951 |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2017-10-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 6853 | AZ | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639521180 | Charles N Gardner | Physical Therapy Assistant | 1056 Mine 10 Rd, Beccaria, PA 16616-9716 | 2016-07-08 |
| 1992010227 | Charles Sperry Gardner | Psychiatry & Neurology | 409 Field Point Rd, Greenwich, CT 06830-7041 | 2010-08-11 |
| 1932237724 | Charles Henry Gardner | Chiropractor | 418 94th Ave N, St Petersburg, FL 33702-2522 | 2007-03-01 |
| 1396825980 | Charles Clifford Gardner Jr. | Surgery | 3420 Buckeye Run, Ft Wayne, IN 46814-8972 | 2006-10-17 |
| 1790102093 | Charles H Gardner Jr. | Counselor | 1012 Union St, Bangor, ME 04401-3060 | 2014-03-25 |
| 1720417090 | Charles Joseph Gardner IIi | Nurse Anesthetist, Certified Registered | 401 W Greenlawn Ave, Lansing, MI 48910-2819 | 2013-11-06 |
| 1801953831 | Charles Joseph Gardner | Chiropractor | 325 N Main St, Belton, TX 76513-3162 | 2007-01-02 |
| 1881763670 | Charles William Gardner Jr. | Family Medicine | 4401 Ford Ave, Suite 250, Alexandria, VA 22302-1473 | 2006-11-07 |
| 1659328656 | Charles Chesley Gardner | Kinesiotherapist | 1201 Broad Rock Blvd, Kt/pm&r/117, Richmond, VA 23249-0001 | 2006-05-27 |
| Street Address |
1600 S 20TH AVE |
| City | SAFFORD |
| State | AZ |
| Zip Code | 85546-4011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316943186 | Richard Hincha | Nurse Anesthetist, Certified Registered | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2005-06-24 |
| 1689209447 | Stephen David Smith | Occupational Therapist | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2020-03-11 |
| 1356982045 | Jami Heap | Dietitian, Registered | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2019-10-03 |
| 1740764059 | Jessica Virginia Cvetic | Physician Assistant | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2018-09-21 |
| 1043791247 | Andrew White | Physician Assistant | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2018-08-24 |
| 1609357946 | Rebecca Ann Dodd | Physician Assistant | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2018-08-24 |
| 1487152963 | Christina Panasci | Occupational Therapist | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2018-01-30 |
| 1609384023 | Tanya Miller | Health Educator | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2018-01-19 |
| 1063926574 | Dionne D Arciero | Occupational Therapy Assistant | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2017-11-20 |
| 1457875544 | Lauren Noel Adams | Occupational Therapist | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2017-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104449628 | The Pain Institute of Southern Arizona PC | Anesthesiology | 2241 W 16th Street, Safford, AZ 85546 | 2020-05-19 |
| 1114490836 | Ponderosa Aviation, Inc | Ambulance | 4500 Aviation Way, Safford, AZ 85546 | 2019-01-04 |
| 1053828160 | Easter Seals Blake Foundation | Community/Behavioral Health | 618 South Central Avenue, Safford, AZ 85546 | 2018-01-10 |
| 1508238700 | Southeastern Arizona Consumer-run Services | Clinic/Center | 628 Main St., Safford, AZ 85546 | 2015-10-27 |
| 1457774465 | Caring Connections for Special Needs, LLC | Community/Behavioral Health | 1952 W Thatcher Blvd, Safford, AZ 85546 | 2014-01-27 |
| 1841634060 | Rs5 Investments LLC | Family Medicine | 1515 S. 20th Ave, Safford, AZ 85546 | 2013-04-18 |
| 1689946162 | South Eastern Arizona Behavioral Health Services, Inc. | Clinic/Center | 1609 S. 1st Ave, Safford, AZ 85546 | 2012-01-31 |
| 1669741435 | Southeastern Arizona Behavioral Health Services, Inc | Clinic/Center | 1609 S 1st Ave, Safford, AZ 85546 | 2011-12-22 |
| 1912295106 | Canyonlands | Clinic/Center | 618 S. Central Avenue, Safford, AZ 85546 | 2011-07-21 |
| 1255669354 | Dovetree Counseling Associates, Inc. | Community/Behavioral Health | 1906 Thatcher Blvd, Safford, AZ 85546 | 2009-12-01 |
| Find all providers in zip 85546 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558465021 | Ronald L Mcadam | Emergency Medicine | 1600 S. 20th Avenue, Mt Graham Regional Medical Center, Safford, AZ 85546 | 2006-09-12 |
| 1215256813 | David Ryan Bryce | Emergency Medicine | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2010-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627815 | Fep Ncch | Emergency Medicine | 8825 N 23rd Ave Ste 100, Phoenix, AZ 85021-4148 | 2020-10-22 |
| 1780202804 | Cep America- Arizona, PC | Emergency Medicine | 1405 S. Alma School Rd., Chandler, AZ 85286 | 2020-07-07 |
| 1932755006 | Ucc Tucson Holdings, LLC. | Emergency Medicine | 18773 S Nogales Hwy Ste 125, Green Valley, AZ 85614-0403 | 2019-08-14 |
| 1831652189 | Derek Allan Hatfield | Emergency Medicine | 1625 N Campbell Ave., Tucson, AZ 85719 | 2019-04-12 |
| 1053874305 | Travis Patrick Martin | Emergency Medicine | 1625 N. Campbell Ave, Tucson, AZ 85719 | 2019-04-12 |
| 1245793504 | Martin Cisneroz | Emergency Medicine | 1625 North Campbell Avenue, Tucson, AZ 85719 | 2019-04-12 |
| 1174086722 | Sarah Joy Ring | Emergency Medicine | 1625 N. Campbell Ave., Tucson, AZ 85719 | 2019-04-10 |
| 1386106391 | Joshua Lee Price | Emergency Medicine | 708 S Coeur D Alene Ln Ste A, Payson, AZ 85541-5662 | 2019-04-01 |
| 1346708708 | Colonna Physician Services LLC | Emergency Medicine | 4030 N Stockton Hill Rd Ste 3, Kingman, AZ 86409-2452 | 2019-03-05 |
| 1609304633 | Vincent Guarino | Emergency Medicine | 5700 E, Az-90, Sierra Vista, AZ 85635 | 2017-06-04 |
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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.