Duwayne Gardner, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

14127 Issued in TX

Practice address

1069 County Road 200
Weimar, TX 78962-5204

Phone

(979) 253-8459

NPI assigned

May 11, 2020

Last updated

Mar 15, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• At Home Chiropractic LLC

  • Chiropractor
  • Weimar, TX
  • NPI 1891542841
  NPD Authorized official

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1588286702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 W STATE HIGHWAY 71 # 526",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789455138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1069 COUNTY ROAD 200",
            "city": "WEIMAR",
            "state": "TX",
            "postal_code": "789625204",
            "telephone_number": "979-253-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "DUWAYNE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-11",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "04055",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "14127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divine Choice Healthcare Services Inc
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• Jorge A Duchicela, M.D.
• Olga I Duchicela, M.D.
• Wendy Lynn Florus, M.S. CCC-SLP
• Leo Dan Gordon, DDS
• Robert R Graham, CRNA
• Hatch
• Loueva Hatfield, M.ED.
• Judi Henneke

• Chiropractor in Weimar, TX
• Providers in Weimar, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.