AUTUMN GARDNER (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1407674120

AUTUMN GARDNER (PMHNP) is a healthcare provider. based in Hanover, Pennsylvania. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. SP030791 (PA). The NPI Number for AUTUMN GARDNER (PMHNP) is 1407674120

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
AUTUMN GARDNER (PMHNP)
NPI
1407674120
Phone
(443) 848-9901
Address
235 PRINCESS ST
Enumeration Date
1 October 2024
Last Update Date
1 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3013300006
Graduation Year
2024 (2 years ago)
PAC ID
9931638798
Group Practice PAC ID
8325283229
Professional Enrollment ID
I20250123000470
Address ID
MD208772605GA702XXAVEX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

11,473 NURSE PRACTITIONER in PA

Provider Addresses for AUTUMN GARDNER (PMHNP)

  • 235 PRINCESS ST

    HANOVER, PA 173312309

    Phone: (443) 848-9901

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250123000470INurse PractitionerDCTBD
I20251002001993INurse PractitionerPATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 17331)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8325283229View full group profile
NameSpecialtyState
Mental Health CounselorMD
-MD
Nurse PractitionerMD
Mental Health CounselorFL
-WV
Nurse PractitionerMD
-DC
Mental Health CounselorMD
Family PracticeVA
Nurse PractitionerVA

Reviews

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Frequently asked questions

How do I look up AUTUMN GARDNER (PMHNP) by NPI?
Use NPI 1407674120 when you need to reference AUTUMN GARDNER (PMHNP) in forms, claims, or directories.
Does this profile mean AUTUMN GARDNER (PMHNP) is currently active?
Yes — AUTUMN GARDNER (PMHNP) appears active in the national provider directory.
Can you summarize AUTUMN GARDNER (PMHNP)'s specialty in plain language?
Clinically, the directory lists AUTUMN GARDNER (PMHNP) with Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location shows for AUTUMN GARDNER (PMHNP)?
We surface Hanover, Pennsylvania for AUTUMN GARDNER (PMHNP) based on available NPPES addresses.
How can I contact AUTUMN GARDNER (PMHNP)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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