Jesse A Wutzke, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1169 Issued in ND

Practice address

4530 Northern Sky Dr
Bismarck, ND 58503-8534

Phone

(701) 751-6336

Fax

(701) 751-6337

NPI assigned

Mar 3, 2011

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

Other names 1

• Jesse A Jacobson Former name

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Pediatric Therapy Partners, Inc.

  • Occupational Therapist
  • Thief River Falls, MN
  • NPI 1457479958

  ND

  Medicare reassignment
• Pediatric Therapy Partners, Inc.

  • Early Intervention Provider Agency
  • Fargo, ND
  • NPI 1104426352
  NPD
• Applied Medical, Inc

  • Occupational Therapist
  • Bismarck, ND
  • NPI 1881665768
  NPD (past)
• Empowered Kids Pediatric Therapy

  • Pediatric Occupational Therapist
  • Bismarck, ND
  • NPI 1164169462
  NPD (past)

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1245538941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 NORTHERN SKY DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585038534",
            "telephone_number": "701-751-6336",
            "fax_number": "701-751-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 NORTHERN SKY DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585038534",
            "telephone_number": "701-751-6336",
            "fax_number": "701-751-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUTZKE",
        "first_name": "JESSE",
        "middle_name": "A",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-03",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSE",
            "last_name": "JACOBSON",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carrie A Wright, OT
• Samantha Wright
• Crystal Wring
• Zongjian Wu, PHD
• Jessica Wurtz, LCSW
• Kelsey Jane Wymore
• Amy Louise Wynkoop, LPCC
• Craig Wysk
• Hai Xu, MD
• Emily J Yanish, LPCC

• Occupational Therapist in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Occupational Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.

Verify at the official NPI Registry.