Individual provider Active NPI

Tania Ann Gednov, OTR/L

  • Specialist
  • Long Beach, CA
National Provider Identifier
1730486069
Registry record updated Feb 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OT0129 Issued in CA
Practice address
5901 E 7TH St
BLDG. 150, OT Dept, Basement
Long Beach, CA 90822-5201
Phone
(562) 493-3545
NPI assigned
Feb 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OT0129 CA Primary

Addresses

Primary practice location

5901 E 7TH St
BLDG. 150, OT Dept, Basement
Long Beach, CA 90822-5201

Mailing address

11912 Cherry St
Los Alamitos, CA 90720-4106
Phone (562) 493-3545

Other identifiers 1

IdentifierTypeStateIssuer
OT0129OtherCASTATE OF CALIFORNIA PROFESSIONAL OCCUPATIONAL THERAPY LICENSE

Other names 1

  • Tania Ann Krywcun Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT0129CAMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1730486069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11912 CHERRY ST",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907204106",
            "telephone_number": "562-493-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 E 7TH ST",
            "address_2": "BLDG. 150, OT DEPT, BASEMENT",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908225201",
            "telephone_number": "562-493-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEDNOV",
        "first_name": "TANIA",
        "middle_name": "ANN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-23",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "OT0129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA PROFESSIONAL OCCUPATIONAL THERAPY LICENSE",
            "identifier": "OT0129",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANIA",
            "last_name": "KRYWCUN",
            "middle_name": "ANN",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; 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.