Individual provider Active NPI

Judith Kramer Gentner, D.C.

  • Chiropractor
  • Lakewood, OH
National Provider Identifier
1922148212
Registry record updated Sep 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1884 Issued in OH
Practice address
13708 Madison Ave
Lakewood, OH 44107-4711
Phone
(216) 221-2008
Fax
(216) 221-6446
NPI assigned
Feb 7, 2007
Last updated
Sep 21, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1884 OH Primary

Addresses

Primary practice location

13708 Madison Ave
Lakewood, OH 44107-4711

Mailing address

13708 Madison Ave
Lakewood, OH 44107-4711
Phone (216) 221-2008

Other identifiers 1

IdentifierTypeStateIssuer
34-1780993OtherOHTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051114000099 OH Practitioner - Chiropractic 8426077017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gentner Chiropractic and Wellness LLCGroup PAC ID 1456626761, 2 clinicians

Practice addresses (Care Compare)

13708 Madison Ave
Lakewood, OH 44107-4711
Phone (216) 221-2008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5980FLMDHand Occupational Therapist
1884OHMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gentner Chiropractic & Wellness LLC Chiropractor CurrentSince Aug 2, 2017 Accepting new patients

Locations

13708 Madison Ave
Lakewood, OH 44107
Phone (216) 221-2008

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1922148212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13708 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074711",
            "telephone_number": "216-221-2008",
            "fax_number": "216-221-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13708 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074711",
            "telephone_number": "216-221-2008",
            "fax_number": "216-221-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTNER",
        "first_name": "JUDITH",
        "middle_name": "KRAMER",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "34-1780993",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.