Gardens at Roundtable

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

GARDENS AT ROUNDTABLE

Practice address

904 South St
Lafayette, IN 47901-1416

Phone

(765) 630-7222

Fax

(765) 807-3210

NPI assigned

Nov 7, 2016

Last updated

Nov 8, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Renee Michelle Tilt, RDN, CSP

Title

Owner & Registered Dietitian

Phone

(765) 630-7222

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1053853168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 SOUTH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479011416",
            "telephone_number": "765-630-7222",
            "fax_number": "765-807-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 SOUTH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479011416",
            "telephone_number": "765-630-7222",
            "fax_number": "765-807-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDENS AT ROUNDTABLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-07",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "TILT",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER & REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "765-630-7222",
        "authorized_official_credential": "RDN, CSP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Gangwer
• Krishna Gannamaneni, MD
• Melissa C Garber
• Jonathan Estiber Garcia-Ventura, CPSP
• Christian Garcia, RBT
• Sandra G Garofalo, NP
• Ashley Garrett
• Tessa Garrow, LMHC, NCC
• Abigail Gascho
• Lindsay J Gebhardt, PMHNP-BC

• Clinical Social Worker in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.