Individual provider Active NPI

Janelle Van Otterloo

  • Orthopedic Physical Therapist
  • Sioux Falls, SD
National Provider Identifier
1174906747
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2621 Issued in SD
Practice address
810 E 23Rd St FL 2
Sioux Falls, SD 57105-2135
Phone
(605) 322-5123
NPI assigned
Jul 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 2621 SD Primary

Addresses

Primary practice location

810 E 23Rd St FL 2
Sioux Falls, SD 57105-2135

Mailing address

809 W Tradewinds St
Sioux Falls, SD 57108-4112
Phone (507) 227-8714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150713002403 MN Practitioner - Physical Therapist in Private Practice 4486967916 Reassigns benefits to 1 organization
I20230607002196 SD Practitioner - Physical Therapist in Private Practice 4486967916 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of BrookingsGroup PAC ID 1052307105, 112 clinicians

Practice addresses (Care Compare)

2311 Yorkshire Dr
Suite 2
Brookings, SD 57006-2446
Phone (605) 697-7336

300 22ND Ave
Brookings, SD 57006-2480
Phone (605) 692-6351

400 22ND Ave
Brookings, SD 57006-2450
Phone (605) 697-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2621SDMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince May 24, 2023 Accepting new patients
Avera McKennan CurrentSince May 24, 2023 Accepting new patients
Sacred Heart Health Services CurrentSince May 24, 2023 Accepting new patients
Mayo Clinic CurrentSince Jun 29, 2015 Accepting new patients
Mayo Clinic CurrentSince Jun 29, 2015 Accepting new patients
Sacred Heart Health Services CurrentSince May 24, 2023 Accepting new patients
City of Brookings CurrentSince May 1, 2024 Accepting new patients
Mayo Clinic Current Accepting new patients
Sacred Heart Health Services Current Accepting new patients
City of Brookings Current Accepting new patients
Avera McKennan Current Accepting new patients
City of Brookings Current Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

300 22nd Ave
Brookings, SD 57006
Phone (605) 692-6351

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

810 E 23rd St
Fl 2
Sioux Falls, SD 57105
Phone (605) 322-5123

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

Organizations & group practices 12

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": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1174906747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 W TRADEWINDS ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571084112",
            "telephone_number": "507-227-8714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E 23RD ST FL 2",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052135",
            "telephone_number": "605-322-5123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN OTTERLOO",
        "first_name": "JANELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "SD",
            "license": "2621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.