Gennessa Orth

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-20-119298 Issued in WI

Practice address

6140 W Executive Drive
Suite B
Mequon, WI 53092-5883

Phone

(262) 788-8088

NPI assigned

Sep 14, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1285304998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 W EXECUTIVE DR STE B",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530924499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 W EXECUTIVE DRIVE",
            "address_2": "SUITE B",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925883",
            "telephone_number": "262-788-8088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 28th St",
            "address_purpose": "LOCATION",
            "city": "Two Rivers",
            "state": "WI",
            "postal_code": "542412321",
            "country_code": "US",
            "telephone_number": "920-901-6303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORTH",
        "first_name": "GENNESSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "WI",
            "license": "RBT-20-119298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Mequon, WI
• Providers in Mequon, WI by specialty
• Behavior Technician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.