Individual provider Active NPI

Elizabeth Marie Zemlicka, OT

  • Occupational Therapist
  • Watertown, SD
National Provider Identifier
1013490952
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1028 Issued in SD
Practice address
901 14TH Ave NE
Watertown, SD 57201-6817
Phone
(605) 954-4264
Fax
(605) 799-1461
NPI assigned
Sep 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1028 SD Primary

Addresses

Primary practice location

901 14TH Ave NE
Watertown, SD 57201-6817

Mailing address

107 1St St SW
Watertown, SD 57201-4208
Phone (701) 202-9048

Other names 1

  • Elizabeth Marie Nutsch Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190111000789 SD Practitioner - Occupational Therapist in Private Practice 7911243969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caring Edge Op LLCGroup PAC ID 6406114131, 36 clinicians

Practice addresses (Care Compare)

1950 E 4TH St
Pierre, SD 57501-4201
Phone (605) 945-6121

901 14TH Ave NE
Watertown, SD 57201-6817
Phone (605) 954-4264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1028SDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Edge Op LLC CurrentSince Oct 17, 2018 Accepting new patients

Locations

815 S Bridgeway Pl
Ste 122
Eagle, ID 83616
Phone (208) 972-0918

2965 E Tarpon Dr
Ste 150
Meridian, ID 83642
Phone 2082879420110

1950 E 4th St
Pierre, SD 57501
Phone (605) 494-3400

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1013490952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 1ST ST SW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572014208",
            "telephone_number": "701-202-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 14TH AVE NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572016817",
            "telephone_number": "605-954-4264",
            "fax_number": "605-799-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEMLICKA",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SD",
            "license": "1028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "NUTSCH",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Watertown, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.