GARDNER FAMILY MEDICINE, INC. NPI 1003011594

Family Medicine in Gardner, MA

NPI 1003011594 Organization Family Medicine CLIA Number 22D0978797 CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP)

About GARDNER FAMILY MEDICINE, INC.

Gardner Family Medicine, Inc. is a primary care provider established in Gardner, Massachusetts specializing in family medicine. The NPI number of Gardner Family Medicine, Inc. is 1003011594 and was assigned on June 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 2141244 (MA). The provider is registered as an organization and their NPI record was last updated one year ago. Gardner Family Medicine, Inc. operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Jennifer Ryan Do (President)

A primary care provider (PCP) like Gardner Family Medicine, Inc. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

The CLIA number of Gardner Family Medicine, Inc. is 22D0978797 registered as a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued to Gardner Family Medicine, Inc. in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

NPI

1003011594

Provider NameGARDNER FAMILY MEDICINE, INC.
Provider Location Address57 CITY HALL AVE GARDNER, MA 01440
Provider Mailing Address57 CITY HALL AVE GARDNER, MA 01440
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date06-15-2007
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.2141244
License StateMA
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Business Address

GARDNER FAMILY MEDICINE, INC.
57 CITY HALL AVE
GARDNER, MA
ZIP 01440
Phone: (978) 630-3862
Fax: (978) 630-4176

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Mailing Address

GARDNER FAMILY MEDICINE, INC.
57 CITY HALL AVE
GARDNER, MA
ZIP 01440
Phone: (978) 630-3862
Fax: (978) 630-4176



Authorized Official

Authorized Official Name JENNIFER RYAN DO
Authorized Official TitlePRESIDENT
Authorized Official Phone(978) 630-3862

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003011594 is:

CLIA Number22D0978797
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate for Provider-Performed Microscopy Procedures (PPMP)

Group Taxonomy


193400000X MULTIPLE SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant214124MAN/A

Taxonomy Description: 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.

Other Providers at the same location


The following 6 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1467427708 JENNIFER RYAN D.O.
Individual
Family Medicine57 CITY HALL AVE
GARDNER, MA 01440
(978) 630-3862
1386610863 AMANDA SPADAZZI M.D.
Individual
Family Medicine57 CITY HALL AVE
GARDNER, MA 01440
(978) 630-3862
1962577262MR. MATTHEW J ENOS PA
Individual
Physician Assistant (Medical)57 CITY HALL AVE
GARDNER, MA 01440
(978) 630-3862
1639442825MRS. CAROL ANNE FURNARI PA
Individual
Physician Assistant57 CITY HALL AVE
GARDNER, MA 01440
(978) 630-3862
1992201925 ERIK WILLIAM WISNIEWSKI FNP
Individual
Nurse Practitioner (Family)57 CITY HALL AVE
GARDNER, MA 01440
(978) 630-3862
1730225582DR. JEFFREY D MOSER D.P.M.
Individual
Podiatrist57 CITY HALL AVE
GARDNER, MA 01440
(978) 630-3862

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.