Individual provider Active NPI

Crystal K Wieneke

  • Personal Care Attendant
  • Norfolk, NE
National Provider Identifier
1619804358
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
H12163458 Issued in NE
Practice address
1503 Glenmore Dr Apt 101
Norfolk, NE 68701-2656
Phone
(402) 841-9088
NPI assigned
May 6, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X H12163458 NE Primary

Addresses

Primary practice location

1503 Glenmore Dr Apt 101
Norfolk, NE 68701-2656

Mailing address

1503 Glenmore Dr
Norfolk, NE 68701-2650
Phone (402) 841-9088

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
H12163458NEMDPersonal Care Attendant

NPI Registry JSON

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

{
    "created_epoch": "1778025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1619804358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 GLENMORE DR",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687012650",
            "telephone_number": "402-841-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 GLENMORE DR APT 101",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687012656",
            "telephone_number": "402-841-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENEKE",
        "first_name": "CRYSTAL",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-06",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NE",
            "license": "H12163458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.