Individual provider Active NPI

Kaci Laine Wilmer, MOTR/L

  • Pediatric Occupational Therapist
  • Roseau, MN
National Provider Identifier
1487579322
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
105206 Issued in MN
Practice address
509 3Rd St NE
Roseau, MN 56751-1113
Phone
(218) 463-1471
NPI assigned
Aug 11, 2026
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 105206 MN Primary

Addresses

Primary practice location

509 3Rd St NE
Roseau, MN 56751-1113

Mailing address

715 Delmore Dr
Roseau, MN 56751-1599
Phone (218) 463-4787

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

LicenseStateTypeSpecialty
105206MNMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Roseau Community School #682 Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1786406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1487579322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 DELMORE DR",
            "city": "ROSEAU",
            "state": "MN",
            "postal_code": "567511599",
            "telephone_number": "218-463-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 3RD ST NE",
            "city": "ROSEAU",
            "state": "MN",
            "postal_code": "567511113",
            "telephone_number": "218-463-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMER",
        "first_name": "KACI",
        "middle_name": "LAINE",
        "credential": "MOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-11",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "105206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseau, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.