Jessika Mae Viola Wheeler, MOT, OTR/L, CLT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

105445 Issued in MN

Practice address

480 Highway 96 E Ste 120
Vadnais Heights, MN 55127-2557

Phone

(848) 665-1482

NPI assigned

Oct 9, 2017

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

• Jessika Mae Viola Lackie Former name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

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 and National Provider Directory roles.

• Novacare Outpatient Rehabilitation East Inc

  dba NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Fridley, MN
  • NPI 1558610519
  Medicare reassignment NPD
• Novacare Outpatient Rehabilitation East Inc

  dba NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Vadnais Heights, MN
  • NPI 1518963909

  Occupational Therapist

  NPD
• Novacare Outpatient Rehabilitation East, Inc.

  dba NovaCare Rehabilitation

  • Rehabilitation Clinic/Center
  • Woodbury, MN
  • NPI 1730720509
  NPD

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1316457989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 OWENS ST S",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825637",
            "telephone_number": "206-948-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 HIGHWAY 96 E STE 120",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551272557",
            "telephone_number": "848-665-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "JESSIKA",
        "middle_name": "MAE VIOLA",
        "credential": "MOT, OTR/L, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-09",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "105445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIKA",
            "last_name": "LACKIE",
            "middle_name": "MAE VIOLA",
            "credential": "MOT, OTR/L, CLT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Viverant, LLC
• Ashley M Vosters, PA-C
• Wal-Mart Stores, Inc. (Vision Center 30-2087)
• Walmart Inc. (Walmart Pharmacy 10-2087)
• Elizabeth A Wegner, MD
• Jennifer Wickman
• Daren J Wickum, M.D.
• Lori Ab Wiggenhorn, MA, LP
• Natia Wilcek, LICSW
• Hope Wilkins, CMT

• Occupational Therapist in Vadnais Heights, MN
• Providers in Vadnais Heights, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.