Active NPI
Keri Walczak
- Physical Rehabilitation Occupational Therapist
- Lakeville, MN
National Provider Identifier
1295219681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- License
- 102753
- Practice address
- 9318 212TH St W
Lakeville, MN 55044-7299 - Phone
- (651) 335-1728
- NPI assigned
- Sep 20, 2018
- Last updated
- Sep 20, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 102753 | MN | Primary |
Addresses
Primary practice location
9318 212TH St W
Lakeville, MN 55044-7299
Mailing address
9318 212TH St W
Lakeville, MN 55044-7299
Other practice location 1
815 Forest Ave
Northfield, MN 55057
Phone (507) 664-8800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537401600000",
"number": "1295219681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9318 212TH ST W",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550447299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9318 212TH ST W",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550447299",
"telephone_number": "651-335-1728"
}
],
"practiceLocations": [
{
"address_1": "815 Forest Ave",
"address_purpose": "LOCATION",
"city": "Northfield",
"state": "MN",
"postal_code": "55057",
"country_code": "US",
"telephone_number": "507-664-8800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALCZAK",
"first_name": "KERI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-20",
"last_updated": "2018-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "MN",
"license": "102753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.