Active NPI
Gwen M Schupbach
- Occupational Therapist
- Ottosen, IA
National Provider Identifier
1154074888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 01046
- Practice address
- 209 110TH St
Ottosen, IA 50570-8501 - Phone
- (515) 341-3851
- NPI assigned
- Feb 2, 2022
- Last updated
- Feb 2, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 01046 | IA | Primary |
Addresses
Primary practice location
209 110TH St
Ottosen, IA 50570-8501
Mailing address
209 110TH St
Ottosen, IA 50570-8501
Phone (515) 341-3851
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
| License | State | Type | Specialty |
|---|---|---|---|
| 01046 | IA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643760000000",
"number": "1154074888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 110TH ST",
"city": "OTTOSEN",
"state": "IA",
"postal_code": "505708501",
"telephone_number": "515-341-3851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 110TH ST",
"city": "OTTOSEN",
"state": "IA",
"postal_code": "505708501",
"telephone_number": "515-341-3851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHUPBACH",
"first_name": "GWEN",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-02",
"last_updated": "2022-02-02",
"certification_date": "2022-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "01046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.