Individual provider Active NPI

Jennifer Anne Gardner McMorris, DC

  • Chiropractor
  • Round Rock, TX
National Provider Identifier
1104432426
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12649 Issued in TX
Practice address
3000 Joe Dimaggio Blvd Ste 54
Round Rock, TX 78665-3996
Phone
(512) 387-3308
NPI assigned
Sep 22, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 12649 TX Primary

Addresses

Primary practice location

3000 Joe Dimaggio Blvd Ste 54
Round Rock, TX 78665-3996

Mailing address

3000 Joe Dimaggio Blvd Ste 54
Round Rock, TX 78665-3996

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12649TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gardner Chiropractic: Family and Wellness Center, PLLC Chiropractor PastSince Sep 27, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1104432426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 JOE DIMAGGIO BLVD STE 54",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786653996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 JOE DIMAGGIO BLVD STE 54",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786653996",
            "telephone_number": "512-387-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER MCMORRIS",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.