Individual provider Active NPI

Annette Priebe, OTR/L

  • Occupational Therapist
  • Chamberlain, SD
National Provider Identifier
1770675233
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0174 Issued in SD
Practice address
200 Paul Gust Rd
Chamberlain, SD 57325-1031
Phone
(605) 234-1287
Fax
(605) 234-1288
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0174 SD Primary

Addresses

Primary practice location

200 Paul Gust Rd
Chamberlain, SD 57325-1031

Mailing address

PO Box 97
Chamberlain, SD 57325-0097
Phone (605) 234-1287

Other identifiers 2

IdentifierTypeStateIssuer
4996061OtherSDWELLMARK BC/BS
5834160MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101207000658 SD Practitioner - Occupational Therapist in Private Practice 4587707971 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0174SDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Queen of Peace CurrentSince Jun 1, 2024 Accepting new patients
Avera Queen of Peace Current Accepting new patients
Avera Queen of Peace CurrentSince Jun 1, 2024 Accepting new patients

Locations

200 Paul Gust Rd
Ste 109
Chamberlain, SD 57325
Phone (605) 234-0165

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

Organizations & group practices 13

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.

View all 13

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Creighton University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera Queen of Peace 122 clinicians

Practice addresses (Care Compare)

200 Paul Gust Rd
Suite 109
Chamberlain, SD 57325-1021
Phone (605) 234-0165

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770675233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "CHAMBERLAIN",
            "state": "SD",
            "postal_code": "573250097",
            "telephone_number": "605-234-1287",
            "fax_number": "605-234-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PAUL GUST RD",
            "city": "CHAMBERLAIN",
            "state": "SD",
            "postal_code": "573251031",
            "telephone_number": "605-234-1287",
            "fax_number": "605-234-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIEBE",
        "first_name": "ANNETTE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SD",
            "license": "0174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC/BS",
            "identifier": "4996061",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5834160",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chamberlain, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.