Janice Ileen Gengenbach, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

325 Issued in NE

Practice address

300 E 12TH St
Cozad, NE 69130-1505

Phone

(308) 784-2261

NPI assigned

Aug 13, 2007

Sex

Female

Sole proprietor

Yes

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, last updated by the provider on Aug 13, 2007.

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1497947527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43540 ROAD 739",
            "city": "SMITHFIELD",
            "state": "NE",
            "postal_code": "689761065",
            "telephone_number": "308-472-5092",
            "fax_number": "308-472-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E 12TH ST",
            "city": "COZAD",
            "state": "NE",
            "postal_code": "691301505",
            "telephone_number": "308-784-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENGENBACH",
        "first_name": "JANICE",
        "middle_name": "ILEEN",
        "name_prefix": "Mrs.",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NE",
            "license": "325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Cozad, NE
• Registered Dietitian in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.