Individual provider Active NPI

Tiffany Yvette Gardner, FNP-C

  • Family Nurse Practitioner
  • Longview, TX
National Provider Identifier
1790257392
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP139694 Issued in TX
Practice address
425 N Fredonia St
Longview, TX 75601-6464
Phone
(903) 758-2610
Fax
(903) 758-7081
NPI assigned
Dec 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP139694 TX Primary

Addresses

Primary practice location

425 N Fredonia St
Longview, TX 75601-6464

Mailing address

1107 E Marshall Ave
Longview, TX 75601-5602
Phone (903) 758-2610

Other practice location 1

1107 E Marshall Ave
Longview, TX 75601-5602
Phone (903) 758-2610

Other practice location 2

825 Medical Dr Ste A
Tyler, TX 75701-2143
Phone (903) 758-2610

Other practice location 3

705 E Marshall Ave Ste 3000
Longview, TX 75601-5661
Phone (903) 758-2610

Other practice location 4

1761 W Loop 281
Longview, TX 75604-2734
Phone (903) 758-2610

Other practice location 5

802 Medical Cir Ste 101
Longview, TX 75605-5169
Phone (903) 758-2610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190516000851 TX Practitioner - Nurse Practitioner 8426391319 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP139694TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Longview Wellness Center Inc CurrentSince Jan 23, 2020 Accepting new patients
Longview Wellness Center, Inc Current Accepting new patients
Longview Wellness Center Inc CurrentSince Jan 23, 2020 Accepting new patients

Locations

1761 W Loop 281
Longview, TX 75604
Phone (903) 297-1733

425 N Fredonia St
Longview, TX 75601
Phone (903) 234-1452

1107 E Marshall Ave
Longview, TX 75601
Phone (903) 212-4763

1701 Pine Tree Rd
Longview, TX 75604
Phone (903) 295-5151

705 E Marshall Ave
Ste 3000
Longview, TX 75601
Phone (903) 212-4763

825 Medical Dr
Tyler, TX 75701
Phone (903) 533-0733

Interoperability endpoints

  • Direct secure messaging: tiffanygardner@wp.medalliesdirect.net

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1790257392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015602",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N FREDONIA ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756016464",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1107 E Marshall Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015602",
            "country_code": "US",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "825 Medical Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012143",
            "country_code": "US",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "705 E Marshall Ave Ste 3000",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015661",
            "country_code": "US",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1761 W Loop 281",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756042734",
            "country_code": "US",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "802 Medical Cir Ste 101",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756055169",
            "country_code": "US",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "TIFFANY",
        "middle_name": "YVETTE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-20",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.