Active NPI
Jean Wallerstein
- Occupational Therapist
- Spearfish, SD
National Provider Identifier
1558550939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0322
- Practice address
- 617 Deerfield CT
Spearfish, SD 57783-1119 - Phone
- (605) 642-2716
- NPI assigned
- Oct 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 0322 | SD | Primary |
Addresses
Primary practice location
617 Deerfield CT
Spearfish, SD 57783-1119
Mailing address
617 Deerfield CT
Spearfish, SD 57783-1119
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 |
|---|---|---|---|
| 0322 | SD | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193011200000",
"number": "1558550939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "617 DEERFIELD CT",
"city": "SPEARFISH",
"state": "SD",
"postal_code": "577831119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "617 DEERFIELD CT",
"city": "SPEARFISH",
"state": "SD",
"postal_code": "577831119",
"telephone_number": "605-642-2716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLERSTEIN",
"first_name": "JEAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-22",
"last_updated": "2007-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SD",
"license": "0322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spearfish, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.