Active NPI
Kasey Catherine Rennicke, COTA/L
- Occupational Therapy Assistant
- Wausau, WI
National Provider Identifier
1316475650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 4971-27
- Practice address
- 2400 Marshall St
Wausau, WI 54403-6738 - Phone
- (715) 848-4306
- NPI assigned
- May 31, 2017
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 4971-27 | WI | Primary |
Addresses
Primary practice location
2400 Marshall St
Wausau, WI 54403-6738
Mailing address
207 W Eldred St Apt 16
Wausau, WI 54401-2687
Phone (920) 840-2910
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4971-27 | WI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496188800000",
"number": "1316475650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 W ELDRED ST APT 16",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544012687",
"telephone_number": "920-840-2910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 MARSHALL ST",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544036738",
"telephone_number": "715-848-4306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNICKE",
"first_name": "KASEY",
"middle_name": "CATHERINE",
"name_prefix": "Ms.",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-31",
"last_updated": "2017-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "4971-27",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.