Active NPI
Ariana J Gardner, ATC
- Physical Therapist
- Jackson, MS
National Provider Identifier
1275115214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1350316
- Practice address
- 1700 Jr Lynch Street
Jackson, MS 39217-0001 - Phone
- (601) 979-2416
- NPI assigned
- Apr 28, 2021
- Last updated
- Aug 3, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1350316 | TX | Primary |
| Athletic Trainer | 2255A2300X | AT0925 | MS |
Addresses
Primary practice location
1700 Jr Lynch Street
Jackson, MS 39217-0001
Mailing address
6803 Cheswick CT
Parker, TX 75002-3027
Phone (662) 374-3006
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 |
|---|---|---|---|
| 1350316 | TX | MD | Physical Therapist |
| AT0925 | MS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659484800000",
"number": "1275115214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6803 CHESWICK CT",
"city": "PARKER",
"state": "TX",
"postal_code": "750023027",
"telephone_number": "662-374-3006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 JR LYNCH STREET",
"city": "JACKSON",
"state": "MS",
"postal_code": "392170001",
"telephone_number": "601-979-2416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "ARIANA",
"middle_name": "J",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-28",
"last_updated": "2022-08-03",
"certification_date": "2022-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1350316",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MS",
"license": "AT0925",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.