Jimmy Tompo Gargar, PMH-NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

148677 Issued in TN

Practice address

4800 Memorial Dr
Waco, TX 76711-1329

Phone

(254) 297-3241

NPI assigned

May 10, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Psychlife Mental Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
  • NPI 1245945682
  NPD (past)

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

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693094400000",
    "number": "1528403045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6717 MUNDO DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767126668",
            "telephone_number": "254-405-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 MEMORIAL DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767111329",
            "telephone_number": "254-297-3241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 Owen Ln Ste 144A",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767105587",
            "country_code": "US",
            "telephone_number": "254-405-1974",
            "fax_number": "254-362-2064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARGAR",
        "first_name": "JIMMY",
        "middle_name": "TOMPO",
        "credential": "PMH-NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-10",
        "last_updated": "2023-08-27",
        "certification_date": "2023-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP12557",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "148677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Del Consuelo Garcia, RBT
• Randy C Gardell, MD
• Robert A.M. Gardere, M.D.
• Carolyn Gardner, LPC
• Violet Gardner, RBT - 23-253402
• Shannon Garitty, MD
• Emily Holmes Garmon, M.D.
• David William Garrett, DDS
• Nolan Wayne Garrett, LPC
• Jose Manuel Garrido, MD

• Psychiatric/Mental Health Nurse Practitioner in Waco, TX
• Providers in Waco, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2023; 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.