TABITHA JENELL GARDNER APN
NPI 1093254443
Nurse Practitioner in Wauconda, IL

Q: What is Tabitha Gardner's NPI number?

The NPI number for Tabitha Gardner is 1093254443. It was assigned to this individual provider in the NPPES registry on February 17, 2017.

Q: What is Tabitha Gardner's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Tabitha Gardner was last updated on December 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 17, 2017PECOS EnrolledAccepts Medicare Assignment

89.57/100

CMS Quality Rating

431 W LIBERTY ST, WAUCONDA, IL 60084(847) 526-2151(847) 526-2017 Get Directions Write a Review

NPPES record last updated: December 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 10, 2025, Nov 11, 2025, Oct 10, 2025 and 2 more (5 updates tracked since 2017).

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About Tabitha Jenell Gardner Apn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TABITHA JENELL GARDNER APN (NPI 1093254443) is an individual nurse practitioner in Wauconda, Illinois, licensed in Tennessee (27517) and active in the NPI registry since February 2017. She is enrolled in Medicare PECOS, maintains a secondary practice location in Virginia Beach, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1093254443

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameTABITHA JENELL GARDNERCredential: APN

Location Address431 W LIBERTY STWauconda, IL 60084-2452

Mailing Address1005 Dr Db Todd Jr BlvdNashville, TN 37208-3501 · (615) 327-5944 · Fax (615) 327-5597

Phone(847) 526-2151

Fax(847) 526-2017

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateFebruary 17, 2017

Last NPPES UpdateDecember 10, 20255 updates tracked since enumeration

NPPES CertifiedDecember 10, 2025

✔ NPI 1093254443 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in TN · 27517

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 209015188 (IL), 0024182795 (VA), GAA-NP001979 (GA)

431 W LIBERTY ST, Wauconda, IL 60084

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Secondary Practice Location 1

Location 11300 Sentara Park # 3Virginia Beach, VA 23464-5884 · Phone (757) 252-3050 · Fax (757) 222-3106

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas, Inc., BlueCross BlueShield of Tennessee, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tabitha Jenell Gardner Apn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729362199

PECOS Enrollment IDI20191002001025, I20210811001744

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60084 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$93.02 typical visit price

range $59.81 – $181.38

Typical copayment $23.25 (range $14.95 – $45.34)

Most-billed visit code 99203

Established Patient

$105.07 typical visit price

range $19.15 – $147.12

Typical copayment $26.26 (range $4.78 – $36.78)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

89.57/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

65.45

Promoting Interoperability

Improvement Activities

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTINE M REDMOND APRN, NP-C

Nurse Practitioner (Family)