Individual provider Active NPI

Anquinette Michelle Gardner, NEMT TRANSPORTATION

  • Vehicle Modifications Contractor
  • Conway, AR
National Provider Identifier
1790305803
Registry record updated Apr 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vehicle Modifications ContractorTaxonomy code 171WV0202X
Practice address
911 Chestnut St # 5
Conway, AR 72032-4301
Phone
(501) 404-0666
Fax
(501) 404-9722
NPI assigned
Apr 18, 2020
Last updated
Apr 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vehicle Modifications Contractor 171WV0202X Primary

Addresses

Primary practice location

911 Chestnut St # 5
Conway, AR 72032-4301

Mailing address

911 Chestnut St # 5
Conway, AR 72032-4301
Phone (501) 404-0666

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

Practice roles

OrganizationSpecialtyStatusNew patients
501 Non-Emergency Medical Central Transit, LLC. Current Accepting new patients
501 Non-Emergency Medical Central Transit, LLC. Current Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1587168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587168000000",
    "number": "1790305803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 CHESTNUT ST # 5",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324301",
            "telephone_number": "501-404-0666",
            "fax_number": "501-404-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 CHESTNUT ST # 5",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324301",
            "telephone_number": "501-404-0666",
            "fax_number": "501-404-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "ANQUINETTE",
        "middle_name": "MICHELLE",
        "credential": "NEMT TRANSPORTATION",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-18",
        "last_updated": "2020-04-18",
        "certification_date": "2020-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WV0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Vehicle Modifications",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2020; 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.