Active NPI
Jennifer R Fardink, LM, CPM
- Midwife
- Clarksville, TN
National Provider Identifier
1497063671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 99102
- Practice address
- 1477 Tiny Town Rd # 252
Clarksville, TN 37042-7202 - Phone
- (928) 919-4566
- NPI assigned
- Sep 21, 2010
- 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 |
|---|---|---|---|---|
| Midwife | 176B00000X | 99102 | TX | Primary |
Addresses
Primary practice location
1477 Tiny Town Rd # 252
Clarksville, TN 37042-7202
Mailing address
1477 Tiny Town Rd # 252
Clarksville, TN 37042-7202
Phone (928) 919-4566
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
| License | State | Type | Specialty |
|---|---|---|---|
| 99102 | TX | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536192000000",
"number": "1497063671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1477 TINY TOWN RD # 252",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370427202",
"telephone_number": "928-919-4566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1477 TINY TOWN RD # 252",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370427202",
"telephone_number": "928-919-4566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARDINK",
"first_name": "JENNIFER",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "LM, CPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-21",
"last_updated": "2018-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "TX",
"license": "99102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.