Active NPI
Jennifer Lynn Gfall, COTA
- Occupational Therapy Assistant
- New Richmond, WI
National Provider Identifier
1922396795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 4832-27
- Practice address
- 1445 N 4TH St
New Richmond, WI 54017-1063 - Phone
- (715) 246-8297
- NPI assigned
- Jul 14, 2011
- Last updated
- Mar 13, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 4832-27 | WI | Primary |
Addresses
Primary practice location
1445 N 4TH St
New Richmond, WI 54017-1063
Mailing address
964 Winding Trail Rd.
New Richmond, WI 54017
Phone (810) 240-5121
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 |
|---|---|---|---|
| 4832-27 | WI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678665600000",
"number": "1922396795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "964 WINDING TRAIL RD.",
"city": "NEW RICHMOND",
"state": "WI",
"postal_code": "54017",
"telephone_number": "810-240-5121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1445 N 4TH ST",
"city": "NEW RICHMOND",
"state": "WI",
"postal_code": "540171063",
"telephone_number": "715-246-8297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GFALL",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-14",
"last_updated": "2023-03-13",
"certification_date": "2023-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "4832-27",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Richmond, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.