Active NPI
Tara Lynn Gardner, D.C.
- Chiropractor
- Conway, AR
National Provider Identifier
1053373555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1598
- Practice address
- 813 Oak St
Suite 7
Conway, AR 72032-4473 - Phone
- (501) 329-2700
- Fax
- (501) 329-5282
- NPI assigned
- Apr 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1598 | AR | Primary |
Addresses
Primary practice location
813 Oak St
Suite 7
Conway, AR 72032-4473
Mailing address
813 Oak St
Suite 7
Conway, AR 72032-4473
Phone (501) 329-2700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 148126718 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1598 | AR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296172800000",
"number": "1053373555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "813 OAK ST",
"address_2": "SUITE 7",
"city": "CONWAY",
"state": "AR",
"postal_code": "720324473",
"telephone_number": "501-329-2700",
"fax_number": "501-329-5282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813 OAK ST",
"address_2": "SUITE 7",
"city": "CONWAY",
"state": "AR",
"postal_code": "720324473",
"telephone_number": "501-329-2700",
"fax_number": "501-329-5282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "TARA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-03",
"last_updated": "2011-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AR",
"license": "1598",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "148126718",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.