TABITHA JENELL GARDNER (APN) – Nurse Practitioner, NPI 1093254443
Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for TABITHA JENELL GARDNER (APN)
PO BOX 6037
WAUCONDA, IL 600846037
Phone: (847) 526-2151
Fax: (847) 526-2017
Type: Mailing
1005 DR DB TODD JR BLVD
NASHVILLE, TN 372083501
Phone: (615) 327-5944
Fax: (615) 327-5597
Type: Mailing
1300 Sentara Park # 3
Virginia Beach, VA 234645884
Phone: (757) 252-3050
Fax: (757) 222-3106
Type: Location
431, West Liberty Street, Wauconda, Lake County, Illinois, 60084, United States
WAUCONDA, IL 600842452
Phone: (847) 526-2151
Fax: (847) 526-2017
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-08-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191002001025 | I | Nurse Practitioner | MN | TBD |
| I20210811001744 | I | Nurse Practitioner | TN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60084)
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