Individual provider Active NPI

Carmen Rae Repnow, OT

  • Occupational Therapist
  • Bismarck, ND
National Provider Identifier
1568616670
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1056 Issued in ND
Practice address
401 N 9TH St
Bismarck, ND 58501-4530
Phone
(701) 712-4500
NPI assigned
Nov 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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 1056 ND Primary

Addresses

Primary practice location

401 N 9TH St
Bismarck, ND 58501-4530

Mailing address

401 N 9TH St
Bismarck, ND 58501-4530
Phone (701) 712-4500

Other practice location 1

2700 State St
Suite 1
Bismarck, ND 58503-0669
Phone (701) 712-4237

Other identifiers 1

IdentifierTypeStateIssuer
1452422MedicaidND

Other names 1

  • Carmen Schempp Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090120000152 ND Practitioner - Occupational Therapist in Private Practice 1052474962 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovis Health LLCGroup PAC ID 9931298155, 561 clinicians

Practice addresses (Care Compare)

3000 32ND Ave S
Fargo, ND 58103-6132
Phone (701) 364-8000

401 N 9TH St
Bismarck, ND 58501-4530
Phone (701) 712-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1056NDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health LLC CurrentSince Oct 1, 2022 Accepting new patients
Innovis Health, LLC Current Accepting new patients
Innovis Health, LLC. CurrentSince Oct 1, 2022 Accepting new patients
Applied Medical, Inc Occupational Therapist Past Accepting new patients

Locations

2700 State St
Ste 1
Bismarck, ND 58503
Phone (701) 712-4237

401 N 9th St
Bismarck, ND 58501
Phone (701) 530-6000

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

Organizations & group practices 5

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": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1568616670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014530",
            "telephone_number": "701-712-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014530",
            "telephone_number": "701-712-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 State St",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585030669",
            "country_code": "US",
            "telephone_number": "701-712-4237",
            "fax_number": "701-712-4236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REPNOW",
        "first_name": "CARMEN",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-17",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452422",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARMEN",
            "last_name": "SCHEMPP",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.