MEDICARE: RENEE KNEIP O.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	0133	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1780849869	OTHER		BCBSMN
2	1780849869	OTHER	SD	WELLMARK BCBS; TRICARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	9290501	OTHER	SD	DAKOTACARE

General Provider Information

NPI Number	:	1780849869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE KNEIP O.T.

Provider Business Mailing Address
First Line	:	PO BOX 5045
Second Line	:	ATTN: PROV ENROLLMENT
City	:	SIOUX FALLS
State	:	SD
Zip	:	57117-5045
Country	:	US
Telephone Number	:	605-322-6428
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 S PRINCE OF PEACE PL
Second Line	:	SUITE 1
City	:	SIOUX FALLS
State	:	SD
Zip	:	57103-5830
Country	:	US
Telephone Number	:	605-322-5600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	06/21/2010

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Directions to “ RENEE KNEIP O.T.” Practice Location

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