Individual provider Active NPI

Gretchen S Chappell, OTR/L

  • Occupational Therapist
  • Omaha, NE
National Provider Identifier
1518260223
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
808 Issued in NE
Practice address
13336 Industrial Rd
Suite 105
Omaha, NE 68137-1124
Phone
(402) 330-3211
Fax
(402) 330-5970
NPI assigned
Dec 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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 808 NE Primary

Addresses

Primary practice location

13336 Industrial Rd
Suite 105
Omaha, NE 68137-1124

Mailing address

13336 Industrial Rd
Suite 105
Omaha, NE 68137-1124
Phone (402) 330-3211

Other identifiers 1

IdentifierTypeStateIssuer
47065477702MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240227001511 SC Practitioner - Occupational Therapist in Private Practice 3476732017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Outpatient Rehabilitation Services LLCGroup PAC ID 8022272848, 199 clinicians

Practice addresses (Care Compare)

3117 W Palmetto St
Florence, SC 29501-5998
Phone (803) 223-7765

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4003SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Jan 16, 2024 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Jan 16, 2024 Accepting new patients
Procare3, Inc. PastSince Jan 1, 2006 Accepting new patients
Makovicka Harms Group PC Occupational Therapist Past Accepting new patients

Locations

303 N Hurstbourne Pkwy
Ste 200
Louisville, KY 40222
Phone (502) 213-7572

3117 W Palmetto St
Florence, SC 29501
Phone (803) 223-7765

2065 McCrays Mill Rd
Sumter, SC 29154
Phone (502) 213-7575

Organizations & group practices 4

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": "1292803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1518260223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13336 INDUSTRIAL RD",
            "address_2": "SUITE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371124",
            "telephone_number": "402-330-3211",
            "fax_number": "402-330-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13336 INDUSTRIAL RD",
            "address_2": "SUITE 105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681371124",
            "telephone_number": "402-330-3211",
            "fax_number": "402-330-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPPELL",
        "first_name": "GRETCHEN",
        "middle_name": "S",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-20",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47065477702",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.