Individual provider Active NPI

James Gardner, D.C.

  • Chiropractor
  • Tyler, TX
National Provider Identifier
1285041087
Registry record updated Mar 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12680 Issued in TX
Practice address
3316 Woods Blvd
Tyler, TX 75707-1656
Phone
(903) 787-5925
Fax
(903) 787-5926
NPI assigned
Jul 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12680 TX Primary

Addresses

Primary practice location

3316 Woods Blvd
Tyler, TX 75707-1656

Mailing address

3316 Woods Blvd
Tyler, TX 75707-1656
Phone (903) 787-5925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150120001126 TX Practitioner - Chiropractic 4284958349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gardner Chiropractic, P.a.Group PAC ID 3375867435, 2 clinicians

Practice addresses (Care Compare)

3728 Southpark Dr
Suite 100
Tyler, TX 75703-1707
Phone (903) 787-5925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12680TXMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Gardner Chiropractic, PA Chiropractor CurrentSince Nov 10, 2014 Accepting new patients

Locations

3728 Southpark Dr
Ste 100
Tyler, TX 75703

3728 Southpark Dr
#100
Tyler, TX 75703
Phone (903) 787-5925

3316 Woods Blvd
Tyler, TX 75707
Phone (903) 787-5925

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": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1285041087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 WOODS BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757071656",
            "telephone_number": "903-787-5925",
            "fax_number": "903-787-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 WOODS BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757071656",
            "telephone_number": "903-787-5925",
            "fax_number": "903-787-5926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.