Active NPI
Lisa Renae Wenzl, OTD
- Occupational Therapist
- Auburn, NE
National Provider Identifier
1235480690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1272
- Practice address
- 1322 U St
Auburn, NE 68305-3215 - Phone
- (402) 274-6164
- NPI assigned
- Sep 26, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1272 | NE | Primary |
Addresses
Primary practice location
1322 U St
Auburn, NE 68305-3215
Mailing address
64107 733 Rd
Auburn, NE 68305-8522
Phone (402) 540-3410
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210202003146 | NE | Practitioner - Occupational Therapist in Private Practice | 9335553395 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1272 | NE | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348617600000",
"number": "1235480690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64107 733 RD",
"city": "AUBURN",
"state": "NE",
"postal_code": "683058522",
"telephone_number": "402-540-3410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1322 U ST",
"city": "AUBURN",
"state": "NE",
"postal_code": "683053215",
"telephone_number": "402-274-6164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENZL",
"first_name": "LISA",
"middle_name": "RENAE",
"credential": "OTD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-26",
"last_updated": "2012-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "1272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.