Marianne S Gengenbach, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

CH6510 Issued in FL

Practice address

989 Rehwinkel Rd
Crawfordville, FL 32327-3456

Phone

(850) 590-8334

Fax

(850) 926-4278

NPI assigned

Apr 27, 2015

Last updated

Apr 27, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1679950836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 REHWINKEL RD",
            "city": "CRAWFORDVILLE",
            "state": "FL",
            "postal_code": "323273456",
            "telephone_number": "850-590-8334",
            "fax_number": "850-926-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 REHWINKEL RD",
            "city": "CRAWFORDVILLE",
            "state": "FL",
            "postal_code": "323273456",
            "telephone_number": "850-590-8334",
            "fax_number": "850-926-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENGENBACH",
        "first_name": "MARIANNE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6510",
            "primary": false
        },
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "FL",
            "license": "CH6510",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "FL",
            "license": "CH6510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Physician Chiropractor in Crawfordville, FL
• Providers in Crawfordville, FL by specialty
• Sports Physician Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.