Nichole Danielle Gentzsch, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2012038310 Issued in MO

Practice address

1195 Choctaw Ridge Dr
Holts Summit, MO 65043-1488

Phone

(573) 353-2121

NPI assigned

Jul 30, 2021

Sex

Female

Sole proprietor

Yes

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, last updated by the provider on Jul 30, 2021.

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1801569207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1195 CHOCTAW RIDGE DR",
            "city": "HOLTS SUMMIT",
            "state": "MO",
            "postal_code": "650431488",
            "telephone_number": "573-353-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 CHOCTAW RIDGE DR",
            "city": "HOLTS SUMMIT",
            "state": "MO",
            "postal_code": "650431488",
            "telephone_number": "573-353-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTZSCH",
        "first_name": "NICHOLE",
        "middle_name": "DANIELLE",
        "name_prefix": "Miss",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2012038310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Marie Cash, APRN, FNP-BC
• Linda Faye Cook, RPH
• Curtis W Dyer, MD
• Stephanie Eddy, LCSW
• James R Ennis, DO
• Allison Gohring, ED.D, BCBA, LBA
• Guthrie Enterprises, Inc.
• Sarah Highland
• Lindsey Diane Holt, MOTR/L
• Samuel Hughes, M.D.

• All providers in Holts Summit, MO
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.