Active NPI
Jennifer Lynn Gardner, M.D.
- Psychiatry Physician
- Jacksonville, AR
National Provider Identifier
1972862225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- E-10146
- Practice address
- 2126 N 1St St Ste F
Jacksonville, AR 72076-2868 - Phone
- (501) 982-5000
- Fax
- (801) 982-5007
- NPI assigned
- May 7, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | E-10146 | AR | Primary |
Addresses
Primary practice location
2126 N 1St St Ste F
Jacksonville, AR 72076-2868
Mailing address
1815 Pleasant Grove Rd
Jonesboro, AR 72401-7870
Phone (870) 933-6886
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-10146 | AR | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1972862225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 PLEASANT GROVE RD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724017870",
"telephone_number": "870-933-6886",
"fax_number": "870-933-9395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2126 N 1ST ST STE F",
"city": "JACKSONVILLE",
"state": "AR",
"postal_code": "720762868",
"telephone_number": "501-982-5000",
"fax_number": "801-982-5007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-07",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AR",
"license": "E-10146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.