Jennifer A Garris, EMTB

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

000385583 Issued in IL

Practice address

332A Saint Paul St
Columbia, IL 62236-1872

Phone

(618) 830-0428

NPI assigned

Sep 24, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253750400000",
    "number": "1578897567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332A SAINT PAUL ST",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361872",
            "telephone_number": "618-281-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332A SAINT PAUL ST",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361872",
            "telephone_number": "618-830-0428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRIS",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "EMTB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-24",
        "last_updated": "2009-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "IL",
            "license": "000385583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Basic Emergency Medical Technician in Columbia, IL
• Providers in Columbia, IL by specialty
• Basic Emergency Medical Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2009; 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.