Active NPI
Jamie Marie Wiesner, OTR/L
- Occupational Therapist
- Brandt, SD
National Provider Identifier
1790919231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0588
- Practice address
- 308 Main St
Brandt, SD 57218-2010 - Phone
- (605) 876-3481
- NPI assigned
- May 12, 2009
- Last updated
- May 12, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0588 | SD | Primary |
| Occupational Therapist | 225X00000X | 103448 | MN |
Addresses
Primary practice location
308 Main St
Brandt, SD 57218-2010
Mailing address
308 Main St
Brandt, SD 57218-2010
Phone (605) 876-3481
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 |
|---|---|---|---|
| 103448 | MN | MD | Occupational Therapist |
| 0588 | SD | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242086400000",
"number": "1790919231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 MAIN ST",
"city": "BRANDT",
"state": "SD",
"postal_code": "572182010",
"telephone_number": "605-876-3481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 MAIN ST",
"city": "BRANDT",
"state": "SD",
"postal_code": "572182010",
"telephone_number": "605-876-3481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIESNER",
"first_name": "JAMIE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-12",
"last_updated": "2009-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SD",
"license": "0588",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "103448",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandt, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.