Patricia Neidviecky, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

1387 Issued in ND

Practice address

4575 23Rd Ave S Ste 400
Fargo, ND 58104-8783

Phone

(701) 347-1782

NPI assigned

Dec 29, 2015

Last updated

Mar 10, 2025By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Myna Early Intervention LLC

  • Early Intervention Provider Agency
  • Fargo, ND
  • NPI 1639981343
  NPD
• Myna Therapy Services PLLC

  • Multi-Specialty Clinic/Center
  • Fargo, ND
  • NPI 1427788629
  NPD

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1114382587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4575 23RD AVE S STE 400",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048783",
            "telephone_number": "701-347-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4575 23RD AVE S STE 400",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048783",
            "telephone_number": "701-347-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIDVIECKY",
        "first_name": "PATRICIA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-29",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ND",
            "license": "1387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Kirimi Ndege
• Nwachan I Ndi
• Anesia Nahimana Ndikubwimana
• Marcus James Neadeau Sr.
• Kaitlan Elizabeth Neard
• Tom Ray Neihart, DDS
• Nela Health Agency
• Sarah Elaine Nell
• Lynn E Nellermoe, CRNA
• Rachel K Nelles, FNP

• Occupational Therapy Assistant in Fargo, ND
• Providers in Fargo, ND by specialty
• Occupational Therapy Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.