Individual provider Active NPI

Nancy Gentz Cipov, OTR

  • Occupational Therapist
  • Milwaukee, WI
National Provider Identifier
1033304076
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3793026 Issued in WI
Practice address
316 N Milwaukee St
Suite 208
Milwaukee, WI 53202-5308
Phone
(888) 389-9030
Fax
(888) 389-9031
NPI assigned
Sep 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3793026 WI Primary

Addresses

Primary practice location

316 N Milwaukee St
Suite 208
Milwaukee, WI 53202-5308

Mailing address

6128 Four Mile Rd
Racine, WI 53402
Phone (262) 639-0143

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

State licenses

LicenseStateTypeSpecialty
3793026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Healthcare Group LLC Past Accepting new patients
Heritage Healthcare Group, LLC Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1033304076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6128 FOUR MILE RD",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "53402",
            "telephone_number": "262-639-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 N MILWAUKEE ST",
            "address_2": "SUITE 208",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532025308",
            "telephone_number": "888-389-9030",
            "fax_number": "888-389-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIPOV",
        "first_name": "NANCY",
        "middle_name": "GENTZ",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3793026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.