Gina Nicole Gentzkow, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

2035 Issued in ND

Practice address

300 N 7TH St
Bismarck, ND 58501-4439

Phone

(701) 323-6097

NPI assigned

Jun 29, 2015

Last updated

Feb 9, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Gina Nicole Phillips Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1255713012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 W AVENUE C",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013456",
            "telephone_number": "317-966-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N 7TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014439",
            "telephone_number": "701-323-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTZKOW",
        "first_name": "GINA",
        "middle_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05011748A",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "ND",
            "license": "2035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "PHILLIPS",
            "middle_name": "NICOLE",
            "credential": "D.P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Patricia Louise Gereszek, APRN
• Grace Gerhardt
• Joyce E Gerhardt, LCSW
• Nicole Marlane Gerjets, C/RPHT

• Pediatric Physical Therapist in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Pediatric Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.