Gwen R Radke, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1220 Issued in IA

Practice address

4319 NW Urbandale Dr
Urbandale, IA 50322-7910

Phone

(515) 225-4070

NPI assigned

Feb 2, 2007

Last updated

Nov 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Blue Stone Therapy Inc.

  • Physical Medicine & Rehabilitation Physician
  • Urbandale, IA
  • NPI 1932797297
  NPD
• Sports Rehab & Professional Therapy Associates

  • Customized Equipment (DME)
  • Storm Lake, IA
  • NPI 1285772970
  NPD (past)
• Sports Rehab and Professional Therapy Associates Inc

  dba Sports Rehab & Professional Therapy

  • Rehabilitation Clinic/Center
  • Storm Lake, IA
  • NPI 1033289749

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1962540724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N CRAIG DR",
            "city": "CHEROKEE",
            "state": "IA",
            "postal_code": "510121107",
            "telephone_number": "712-261-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4319 NW URBANDALE DR",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503227910",
            "telephone_number": "515-225-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADKE",
        "first_name": "GWEN",
        "middle_name": "R",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "1220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS OF IOWA",
            "identifier": "01760",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Conrad Pudenz
• Aaron Chistopher Quinn, PH.D.
• R&D Dental PLC (Des Moines Dental group)
• Lazaro Rabang, MD
• Hollie Lynn Radig, DC
• Trina M Radske-Suchan, PT
• Adrian Rains, PA-C
• Thomas Michael Ralston, M.D.
• Nicole Ramirez, DC
• Rapha House Health LLC

• Occupational Therapist in Urbandale, IA
• Providers in Urbandale, IA by specialty
• Occupational Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.