Active NPI
Rebecca Ciszek, MOTR/L
- Occupational Therapist
- Gerrardstown, WV
National Provider Identifier
1831564459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119006509
- Practice address
- 192 Byron Rd
Gerrardstown, WV 25420-4594 - Phone
- (708) 275-4752
- NPI assigned
- Dec 8, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1784 | WV | |
| Occupational Therapist | 225X00000X | 0119006509 | VA | Primary |
Addresses
Primary practice location
192 Byron Rd
Gerrardstown, WV 25420-4594
Mailing address
192 Byron Rd
Gerrardstown, WV 25420-4594
Phone (708) 275-4752
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1784 | Other | WV | LISCENCE OF OT |
| 011900659 | Other | VA | LICENSE OF OCCUPATIONAL THERAPY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0119006509 | VA | MD | Occupational Therapist |
| 1784 | WV | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449532800000",
"number": "1831564459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "192 BYRON RD",
"city": "GERRARDSTOWN",
"state": "WV",
"postal_code": "254204594",
"telephone_number": "708-275-4752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "192 BYRON RD",
"city": "GERRARDSTOWN",
"state": "WV",
"postal_code": "254204594",
"telephone_number": "708-275-4752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CISZEK",
"first_name": "REBECCA",
"credential": "MOTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-08",
"last_updated": "2015-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WV",
"license": "1784",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119006509",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LISCENCE OF OT",
"identifier": "1784",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE OF OCCUPATIONAL THERAPY",
"identifier": "011900659",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gerrardstown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.