Individual provider Active NPI

Alice Gentzler Genung, NP

  • Family Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1750499018
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP13037 Issued in CA
Practice address
659 Cherry St
Santa Rosa, CA 95604
Phone
(707) 526-8300
Fax
(707) 526-8310
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP13037 CA Primary

Addresses

Primary practice location

659 Cherry St
Santa Rosa, CA 95604

Mailing address

659 Cherry St
Santa Rosa, CA 95604
Phone (707) 526-8300

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP13037CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Strategies Inc a Psychological Corp Past Accepting new patients

Organizations & group practices 1

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750499018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 CHERRY ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95604",
            "telephone_number": "707-526-8300",
            "fax_number": "707-526-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 CHERRY ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95604",
            "telephone_number": "707-526-8300",
            "fax_number": "707-526-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTZLER GENUNG",
        "first_name": "ALICE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP13037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.