Emily Yoon Penk-Smith, OTR/L, CLT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

103097 Issued in MN

Practice address

1600 University Ave W
10
Saint Paul, MN 55104-3898

Phone

(651) 646-7246

Fax

(651) 641-0726

NPI assigned

Aug 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Shakopee Mdewakanton Sioux Community

  • Family Medicine Physician
  • Prior Lake, MN
  • NPI 1013933381
  Medicare reassignment NPD

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1720488711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY AVE W",
            "address_2": "10",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043898",
            "telephone_number": "651-646-7246",
            "fax_number": "651-641-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY AVE W",
            "address_2": "10",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043898",
            "telephone_number": "651-646-7246",
            "fax_number": "651-641-0726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENK-SMITH",
        "first_name": "EMILY",
        "middle_name": "YOON",
        "credential": "OTR/L, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Pelzer, CRNA
• Joseph Michael Pendal, LADC, LPCC
• Jennifer Pendleton, LMFT
• Virginia Pendleton, RN
• Kathleen Elizabeth Pengelly, CNP
• Amy Pennig, CNP
• Patricia E Penovich, MD
• Penzi Home Healthcare Agency LLC
• People Diversified Health Care Corp
• People Diversified Healthcare Corp

• Occupational Therapist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.