Active NPI
Kyle Gardner, DC
- Chiropractor
- Austin, TX
National Provider Identifier
1528625407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 14129
- Practice address
- 4316 James Casey St
Austin, TX 78745-1116 - Phone
- (512) 442-2727
- Fax
- (512) 442-2728
- NPI assigned
- May 25, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 14129 | TX | Primary |
Addresses
Primary practice location
4316 James Casey St
Austin, TX 78745-1116
Mailing address
4316 James Casey St
Austin, TX 78745-1116
Phone (512) 442-2727
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14129 | Other | TX | STATE LICENSE |
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 |
|---|---|---|---|
| 14129 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582761600000",
"number": "1528625407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4316 JAMES CASEY ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787451116",
"telephone_number": "512-442-2727",
"fax_number": "512-442-2728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4316 JAMES CASEY ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787451116",
"telephone_number": "512-442-2727",
"fax_number": "512-442-2728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "KYLE",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-25",
"last_updated": "2020-02-27",
"certification_date": "2020-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "14129",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "14129",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.