Gary Tennant DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08002905A Issued in IN

Legal business name

GARY TENNANT DC

Doing business as

Functional Medicine Valparaiso

Practice address

2590 Morthland Dr
Valparaiso, IN 46385-6701

Phone

(219) 232-9404

Fax

(219) 293-8011

NPI assigned

Jun 27, 2017

Organization subpart

No

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

Authorized official

Name

Gary Tennant, DC

Title

Owner

Phone

(708) 275-4698

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Functional Medicine Valparaiso Doing business as

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1497276745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2590 MORTHLAND DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463856701",
            "telephone_number": "219-232-9404",
            "fax_number": "219-293-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2590 MORTHLAND DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463856701",
            "telephone_number": "219-232-9404",
            "fax_number": "219-293-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY TENNANT DC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TENNANT",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-275-4698",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002905A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE NUMBER",
            "identifier": "08002905A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Functional Medicine Valparaiso",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mimi Elizabeth Gardner
• Michael Edward Gariup, DMD
• Sudhakar Garlapati, M.D.
• Darryl Garrett
• Gary M. Durak, PH.D., P.C.
• Jacqueline M Gasparovic, MSW, LCSW
• Derek Scott Gasper, D.O
• Jeffrey Gatch, MSW
• Rachel Gatlin, LCSW
• Jeffrey Patrick Gatz, MD

• Chiropractor in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.