Individual provider Active NPI

Tina M Gary

  • Licensed Practical Nurse
  • Bowling Green, KY
National Provider Identifier
1770435398
Registry record updated Feb 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2029918 Issued in KY
Practice address
1300 Campbell LN
Bowling Green, KY 42104-4162
Phone
(270) 782-6900
Fax
(270) 467-0704
NPI assigned
Feb 14, 2026
Last updated
Feb 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2029918 KY Primary

Addresses

Primary practice location

1300 Campbell LN
Bowling Green, KY 42104-4162

Mailing address

142 Crawford St
Millwood, KY 42762-9008
Phone (270) 535-2469

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2029918KYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1771027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771027200000",
    "number": "1770435398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 CRAWFORD ST",
            "city": "MILLWOOD",
            "state": "KY",
            "postal_code": "427629008",
            "telephone_number": "270-535-2469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 CAMPBELL LN",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421044162",
            "telephone_number": "270-782-6900",
            "fax_number": "270-467-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARY",
        "first_name": "TINA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-14",
        "last_updated": "2026-02-14",
        "certification_date": "2026-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "KY",
            "license": "2029918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2026; 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.