Mary Gienko

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

1530 Lincoln Ave
Charleston, IL 61920-3057

Phone

(217) 348-0127

NPI assigned

Jul 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Ccar Industries

  • Developmentally Disabled Services Day Training Agency
  • Charleston, IL
  • NPI 1588701429
  NPD (past)

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1740832237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 LINCOLN AVE",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619203057",
            "telephone_number": "217-348-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 LINCOLN AVE",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619203057",
            "telephone_number": "217-348-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIENKO",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Charleston",
            "affiliation": "N",
            "address_1": "1530 Lincoln Ave",
            "city": "Charleston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "619203057",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Charleston",
            "affiliation": "N",
            "address_1": "1530 Lincoln Ave",
            "city": "Charleston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "619203057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gabriella Marie Garcia, PTA
• Maria Elizabeth Garcia, LAT, ATC
• Sanjay K Garg, M.B.B.S
• Seema Garg
• Todd E Garner, DO
• Brian Wayne Gilbert
• Michael Gillmore, RNFA
• Denise R Glick
• Jenna Marie Gordon
• Amanda Dianne Gough, MS, ATC

• Developmental Therapist in Charleston, IL
• Providers in Charleston, IL by specialty
• Developmental Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; 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.