Jacey Jo Wenner

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

106966 Issued in MN

Practice address

830 Sunrise Dr Ste B
Saint Peter, MN 56082-1203

Phone

(507) 935-3573

NPI assigned

Jun 30, 2022

Last updated

Jul 1, 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Odom Sports Medicine PAGroup PAC ID 0143485607, 63 clinicians

Practice addresses (Care Compare)

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.

• Odom Sports Medicine, P.a.

  dba Odom Health & Wellness

  • Sports Medicine (Family Medicine) Physician
  • Eden Prairie, MN
  • NPI 1275557886
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1225760804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 SUNRISE DR STE B",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560821203",
            "telephone_number": "507-935-3573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 SUNRISE DR STE B",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560821203",
            "telephone_number": "507-935-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENNER",
        "first_name": "JACEY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "106966",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "5937",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Lynn Veith
• Jacob Todd Veness
• Jessica Rae Waldron, MA, LMFT
• Cassandra Walters, PHARMD
• Jeffrey Thomas Weideman, PA-C
• Kimberly J Wernsing, MD
• Shane Earl Wernsing, M.D.
• Mary Elizabeth Westby, ATC
• Peter Lynn Westre, RN CNP
• Bethany Whittier, D.D.S.

• Occupational Therapist in Saint Peter, MN
• Providers in Saint Peter, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.