Active NPI
Renae N Rico, OT
- Occupational Therapist
- Eau Claire, WI
National Provider Identifier
1396301933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6519-26
- Practice address
- 1109 W Clairemont Ave
Eau Claire, WI 54701-6105 - Phone
- (715) 717-4338
- NPI assigned
- May 17, 2019
- Last updated
- Dec 8, 2020
- 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 Therapist | 225X00000X | 6519-26 | WI | Primary |
Addresses
Primary practice location
1109 W Clairemont Ave
Eau Claire, WI 54701-6105
Mailing address
PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700
Other names 1
- Renae N Tjelta
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607385600000",
"number": "1396301933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19070",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543079070",
"telephone_number": "920-496-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1109 W CLAIREMONT AVE",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547016105",
"telephone_number": "715-717-4338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICO",
"first_name": "RENAE",
"middle_name": "N",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-17",
"last_updated": "2020-12-08",
"certification_date": "2020-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "6519-26",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RENAE",
"last_name": "TJELTA",
"middle_name": "N",
"credential": "OT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.