Active NPI
Jennifer Renee Vieke, LPTA
- Specialist
- Vincennes, IN
National Provider Identifier
1619228756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 06002687A
- Practice address
- 3801 Old Bruceville Rd
Vincennes, IN 47591-3889 - Phone
- (812) 886-4677
- Fax
- (812) 886-4678
- NPI assigned
- Sep 28, 2012
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 06002687A | IN | Primary |
Addresses
Primary practice location
3801 Old Bruceville Rd
Vincennes, IN 47591-3889
Mailing address
420 N 4TH St
Vincennes, IN 47591-1319
Phone (812) 890-9535
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 |
|---|---|---|---|
| 06002687A | IN | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348790400000",
"number": "1619228756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 N 4TH ST",
"city": "VINCENNES",
"state": "IN",
"postal_code": "475911319",
"telephone_number": "812-890-9535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 OLD BRUCEVILLE RD",
"city": "VINCENNES",
"state": "IN",
"postal_code": "475913889",
"telephone_number": "812-886-4677",
"fax_number": "812-886-4678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIEKE",
"first_name": "JENNIFER",
"middle_name": "RENEE",
"name_prefix": "Ms.",
"credential": "LPTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-28",
"last_updated": "2012-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IN",
"license": "06002687A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vincennes, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.