Tishana Gardener

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

317752 Issued in GA

Practice address

107 N McDonough St
Decatur, GA 30030-3317

Phone

(678) 772-9935

NPI assigned

Jun 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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 and National Provider Directory roles.

• Rehabilitation Physicians of Georgia, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Cumming, GA
  • NPI 1144365750
  NPD

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1801246608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N MCDONOUGH ST",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N MCDONOUGH ST",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303317",
            "telephone_number": "678-772-9935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDENER",
        "first_name": "TISHANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "317752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnny A Garcia, DC
• Kelly Garcia, LMSW
• Mariana Garcia, M.D.
• Toni Garcia
• Yisel Garcia
• Katherine Gardes, LCSW
• Briana Gardner
• Cheryl Gardner, LPC
• Sheree Gardner
• Stephen Andrew Gardner, RN

• Family Nurse Practitioner in Decatur, GA
• Providers in Decatur, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.