SHELBY MICHAEL GARDNER MD
NPI 1275038150
Family Medicine in Ft Wright, KY

Q: What is Shelby Gardner's NPI number?

The NPI number for Shelby Gardner is 1275038150. It was assigned to this individual provider in the NPPES registry on March 24, 2018.

Q: What is Shelby Gardner's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Shelby Gardner was last updated on December 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 24, 2018PECOS EnrolledAccepts Medicare Assignment

86.86/100

CMS Quality Rating

1955 DIXIE HWY, FT WRIGHT, KY 41011(859) 341-6255(859) 547-1197 Get Directions Write a Review

NPPES record last updated: December 16, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 16, 2022, Dec 7, 2022, Jul 28, 2021 and 2 more (5 updates tracked since 2018).

On this page

About Shelby Michael Gardner Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHELBY MICHAEL GARDNER MD (NPI 1275038150) is an individual family medicine provider in Ft Wright, Kentucky, licensed in Kentucky (57360) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS, is affiliated with St Elizabeth Edgewood, and is a graduate of University Of Cincinnati College Of Medicine (2018).

NPPES Registry Identity

NPI1275038150

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameSHELBY MICHAEL GARDNERCredential: MD

Location Address1955 DIXIE HWYFt Wright, KY 41011-2792

Mailing Address2139 Auburn Avenue, Attn: Payor Enrollment 4-7Cincinnati, OH 45219 · (513) 351-9900

Phone(859) 341-6255

Fax(859) 547-1197

Sole ProprietorNo

Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 2018

Enumeration DateMarch 24, 2018

Last NPPES UpdateDecember 16, 20225 updates tracked since enumeration

NPPES CertifiedDecember 16, 2022

✔ NPI 1275038150 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in KY · 57360

Definition

Family 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.

1955 DIXIE HWY, Ft Wright, KY 41011

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shelby Michael Gardner Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3375808769

PECOS Enrollment IDI20210802001814

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

171 services100 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

73 services56 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

53 services53 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

47 services22 patients

Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635

This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.

30 services27 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

29 services28 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

29 services28 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

26 services26 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

22 services19 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

19 services13 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

16 services12 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

15 services15 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

15 services15 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number180035

Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County

Emergency services Birthing friendly

Christ Hospital

Acute Care Hospitals · Cincinnati, OH

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360163

Location2139 Auburn AvenueCincinnati, OH 45219 · Hamilton County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41011 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.86/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Promoting Interoperability

100

Improvement Activities

Cost

56.2

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEREMY M JOHNSTON MD

Family Medicine

1955 DIXIE HWY
FT WRIGHT, KY 41011

Kenton County (859) 341-6255

ORTHOCINCY ORTHOPAEDICS & SPORTS MEDICINE

Orthopaedic Surgery (Sports Medicine)

1955 DIXIE HWY, SUITE K
FT WRIGHT, KY 41011

Kenton County (513) 793-3933

STACEY J MOORE ARNP

Nurse Practitioner (Family)

1955 DIXIE HWY, STE C
FT WRIGHT, KY 41011

Kenton County (859) 341-5550

ALL WOMAN, PLLC

Obstetrics & Gynecology

1955 DIXIE HWY, STE C
FT WRIGHT, KY 41011

Kenton County (859) 341-5550

REBECCA L TACKETT ARNP

Nurse Practitioner (Family)

1955 DIXIE HWY, SUITE D
FT WRIGHT, KY 41011

Kenton County (859) 341-5757

RACHEL LYNN FEINAUER D.O.

Internal Medicine

1955 DIXIE HWY
FT WRIGHT, KY 41011

Kenton County (859) 341-5757

LITICIA R. ARTHUR PA-C

Physician Assistant (Medical)

1955 DIXIE HWY
FT WRIGHT, KY 41011

Kenton County (859) 292-9176

DR. AUGUSTA MALIN RAWLINS-RADER MD

Family Medicine

1955 DIXIE HWY
FT WRIGHT, KY 41011

Kenton County (859) 341-5757

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shelby Gardner's NPI number?

The NPI number for Shelby Gardner is 1275038150. It was assigned to this individual provider in the NPPES registry on March 24, 2018.

Where is Shelby Gardner located?

Shelby Gardner practices at 1955 Dixie Hwy, Ft Wright, KY 41011. The listed phone number is (859) 341-6255.

What is Shelby Gardner's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shelby Gardner enrolled in Medicare?

Yes. Shelby Gardner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shelby Gardner accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and MedMutual and 1 other insurer list Shelby Gardner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Shelby Gardner affiliated with any hospitals?

According to CMS data, Shelby Gardner is affiliated with St Elizabeth Edgewood and Christ Hospital.

When was this NPI record last updated?

The NPPES record for Shelby Gardner was last updated on December 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.