Active NPI
Kenna Wieczorek, OTD, OTR/L
- Occupational Therapist
- Pierre, SD
National Provider Identifier
1952902165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1123
- Practice address
- 801 E Sioux Ave
Pierre, SD 57501-3323 - Phone
- (605) 224-3162
- NPI assigned
- Nov 4, 2020
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1123 | SD | Primary |
Addresses
Primary practice location
801 E Sioux Ave
Pierre, SD 57501-3323
Mailing address
108 E 4TH Ave
Fort Pierre, SD 57532-2341
Phone (605) 280-3918
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Medicaid | SD |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kenna.wieczorek@avera.org | Direct | |
| Direct Messaging Address | kenna.wieczorek@avera.org | Direct |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1952902165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 E 4TH AVE",
"city": "FORT PIERRE",
"state": "SD",
"postal_code": "575322341",
"telephone_number": "605-280-3918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 E SIOUX AVE",
"city": "PIERRE",
"state": "SD",
"postal_code": "575013323",
"telephone_number": "605-224-3162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIECZOREK",
"first_name": "KENNA",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-04",
"last_updated": "2020-11-04",
"certification_date": "2020-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SD",
"license": "1123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NA",
"state": "SD"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kenna.wieczorek@avera.org",
"affiliation": "N",
"endpointDescription": "email on secure network",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "801 E Sioux Ave",
"city": "Pierre",
"state": "SD",
"country_code": "US",
"postal_code": "575013323",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kenna.wieczorek@avera.org",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "801 E Sioux Ave",
"city": "Pierre",
"state": "SD",
"country_code": "US",
"postal_code": "575013323",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Pierre, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.