Active NPI
Tiffany Gardner, OT
- Physical Rehabilitation Occupational Therapist
- Owasso, OK
National Provider Identifier
1588935654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- License
- OT571
- Practice address
- 6950 Greenbriar Dr
Owasso, OK 74055-7388 - Phone
- (918) 519-2442
- NPI assigned
- Jan 22, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Low Vision Occupational Therapist | 225XL0004X | OT571 | OK | |
| Physical Rehabilitation Occupational Therapist | 225XP0019X | OT571 | OK | Primary |
Addresses
Primary practice location
6950 Greenbriar Dr
Owasso, OK 74055-7388
Mailing address
6950 Greenbriar Dr
Owasso, OK 74055-7388
Other practice location 1
5350 E 31st St Ste 302
Tulsa, OK 74135-5008
Phone (918) 933-4085
Other practice location 2
102 SW Frank Phillips Blvd
Bartlesville, OK 73118-5031
Phone (918) 933-4085
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200456840A | Medicaid | OK |
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 |
|---|---|---|---|
| OT571 | OK | MD | Low Vision Occupational Therapist |
| 571 | OK | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566345600000",
"number": "1588935654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6950 GREENBRIAR DR",
"city": "OWASSO",
"state": "OK",
"postal_code": "740557388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6950 GREENBRIAR DR",
"city": "OWASSO",
"state": "OK",
"postal_code": "740557388",
"telephone_number": "918-519-2442"
}
],
"practiceLocations": [
{
"address_1": "5350 E 31st St Ste 302",
"address_purpose": "LOCATION",
"city": "Tulsa",
"state": "OK",
"postal_code": "741355008",
"country_code": "US",
"telephone_number": "918-933-4085",
"fax_number": "918-779-7794",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "102 SW Frank Phillips Blvd",
"address_purpose": "LOCATION",
"city": "Bartlesville",
"state": "OK",
"postal_code": "731185031",
"country_code": "US",
"telephone_number": "918-933-4085",
"fax_number": "918-779-7794",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GARDNER",
"first_name": "TIFFANY",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-22",
"last_updated": "2019-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "225XL0004X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Low Vision",
"state": "OK",
"license": "OT571",
"primary": false
},
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "OK",
"license": "OT571",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200456840A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Owasso, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.