MR. TIMOTHY WARREN GARDNER (NPI# 1942303946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942303946 |
| Entity Type | Individual |
| Full Name | MR. TIMOTHY WARREN GARDNER |
| Credential | PA-C |
| Practice Address |
630 S Rancho Dr Suite A Las Vegas NV 89106-4873 |
| Mailing Address |
3221 Indian Moon Dr Las Vegas NV 89129-7329 |
| Practice Telephone | 7026364047 |
| Mailing Telephone | 7026364047 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 559 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104043942 | Timothy Elmer Gardner | Dentist | 2210 N Frazier St Ste 120, Conroe, TX 77303-1701 | 2007-04-20 |
| 1245363100 | Timothy A. Gardner | Dentist | 7001 S 900 E Ste 130, Midvale, UT 84047-1719 | 2007-03-13 |
| 1861482465 | Timothy Lee Gardner | Dermatology | 1009 N State of Franklin Access Rd, Johnson City, TN 37604-3693 | 2005-10-25 |
| 1649269499 | Timothy John Gardner | Internal Medicine | 6120 N Mayfair St, Suite 101, Spokane, WA 99208-1033 | 2005-10-14 |
| 1043672165 | Timothy Gardner | Skilled Nursing Facility | 1485 E 34th St, Brooklyn, NY 11234-2601 | 2016-03-28 |
| 1336288794 | Timothy J Gardner | Surgery | 4755 Ogletown Stanton Rd, Room 1218 - Christiana Hospital, Newark, DE 19718-0001 | 2007-02-05 |
| 1336183508 | Timothy M Gardner | Internal Medicine | 1600 S 48th St, Suite 600, Lincoln, NE 68506-1283 | 2006-06-16 |
| 1841249224 | Timothy Logan Gardner | Podiatrist | 10810 Parkside Dr, Suite 202, Knoxville, TN 37934-1979 | 2006-05-10 |
| 1962466938 | Timothy F Gardner | Nurse Practitioner | 4802 Broadway, Gary, IN 46408-4509 | 2006-04-14 |
| 1851387229 | Timothy B Gardner | Internal Medicine | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2005-09-21 |
| Street Address |
630 S RANCHO DR SUITE A |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89106-4873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639171283 | Eberhard Johannes Maendel | Physician Assistant | 630 S Rancho Dr, Suite E, Las Vegas, NV 89106-4873 | 2005-08-12 |
| 1396241048 | Glen Ethan Gillman | Behavioral Analyst | 630 S Rancho Dr, Las Vegas, NV 89106-4873 | 2018-04-02 |
| 1508306218 | Erika Acevedo | Behavioral Analyst | 630 S Rancho Dr, Ste A, Las Vegas, NV 89106-4873 | 2017-02-28 |
| 1033564448 | Jamie Edelman | Behavioral Analyst | 630 S Rancho Dr, Suite A, Las Vegas, NV 89106-4873 | 2016-05-04 |
| 1033564588 | Jamie Johnson | Behavioral Analyst | 630 S Rancho Dr, Ste A, Las Vegas, NV 89106-4873 | 2016-05-03 |
| 1487009239 | Jade Pryor | Behavioral Analyst | 630 S Rancho Dr, A, Las Vegas, NV 89106-4873 | 2016-04-29 |
| 1568826758 | Desirae Wingerter | Behavioral Analyst | 630 S Rancho Dr, A, Las Vegas, NV 89106-4873 | 2016-04-13 |
| 1548624752 | Brittany Berrelleza | Behavioral Analyst | 630 S Rancho Dr, Ste A, Las Vegas, NV 89106-4873 | 2016-04-13 |
| 1225498348 | Grant A Gift Autism Foundation | Behavioral Analyst | 630 S Rancho Dr, Las Vegas, NV 89106-4873 | 2016-03-02 |
| 1477724466 | Select Physical Therapy of Las Vegas Limited Partnership | Durable Medical Equipment & Medical Supplies | 630 S Rancho Dr, Ste D, Las Vegas, NV 89106-4873 | 2008-03-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555772 | Graciela Miranda Cocorpio | Technician | 820 Rancho Ln Suite #40, Las Vegas, NV 89106 | 2020-10-09 |
| 1679101679 | A Better You Wellness Center | Counselor | 320 W Monroe Street, Las Vegas, NV 89106 | 2020-03-27 |
| 1730725177 | Mariah La'neese Jones | Rehabilitation Practitioner | 400 Shadow Lane Ste 106, Las Vegas, NV 89106 | 2019-11-20 |
| 1417592841 | Lourdes Rita Apumayta-paredes | Technician | 820 Rancho Lane, Suite #40, Las Vegas, NV 89106 | 2019-11-08 |
| 1902456551 | Marisela Pena | Technician | 820 Rancho Ln., 25, Las Vegas, NV 89106 | 2019-09-16 |
| 1992368724 | Amber Nicole Mahajan | Nurse Practitioner | 2020 Wellness Way, Suite 300, Las Vegas, NV 89106 | 2019-04-17 |
| 1568924215 | Arlandrea Tarvins | Behavioral Analyst | 1048 Miller Ave, Las Vegas, NV 89106 | 2019-04-02 |
| 1427510361 | Erik Pennell | Student in an Organized Health Care Education/Training Program | 1542 Pinto Ln, 2nd Floor, Las Vegas, NV 89106 | 2019-04-01 |
| 1245702729 | Bruce Mark Babb | Technician | 820 Rancho Lane Ste #40, Las Vegas, NV 89106 | 2018-12-21 |
| 1639649213 | Antonio Ruiz Pelfort | Technician | 1951 Stella Lake St Suite 36, Las Vegas, NV 89106 | 2018-11-27 |
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| 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 |
|---|---|---|---|---|
| 1376165985 | Vanessa E R Pulido Artienda | Physician Assistant | 7829 Strong Water Ct, Las Vegas, NV 89131-8247 | 2020-05-18 |
| 1427697952 | Fabiola Capano | Physician Assistant | 6930 S Cimarron Rd Ste 260, Las Vegas, NV 89113-2135 | 2020-01-01 |
| 1588200521 | Kimberly Hunt | Physician Assistant | 2250 E Flamingo Rd Ste 100, Las Vegas, NV 89119-5170 | 2019-11-25 |
| 1104461433 | Jacqueline Emilia Lindine | Physician Assistant | 7720 W Sahara Ave Ste 103, Las Vegas, NV 89117-2754 | 2019-11-11 |
| 1255973285 | Kirstey Langston | Physician Assistant | 4475 S Eastern Ave Ste 1500, Las Vegas, NV 89119-7826 | 2019-10-10 |
| 1740834050 | Zi Wang | Physician Assistant | 5300 Spring Mountain Rd Ste 112, Las Vegas, NV 89146 | 2019-07-25 |
| 1548825094 | Victoria Ashlyn James Hinton | Physician Assistant | 5775 S Fort Apache Rd Ste 120, Las Vegas, NV 89148-5627 | 2019-05-09 |
| 1275007205 | Kathy Ann Tran | Physician Assistant | 401 N Buffalo Dr Ste 200, Las Vegas, NV 89145-0397 | 2019-01-12 |
| 1144717067 | Lynne Barbara Ulevich | Physician Assistant | 9310 S Eastern Ave Ste 122, Las Vegas, NV 89123-6844 | 2018-04-16 |
| 1104326727 | Amanda Howe Parker Bartlett | Physician Assistant | 7170 Smoke Ranch Rd Ste 110, Las Vegas, NV 89128-3208 | 2018-02-20 |
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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.