Basic Information
| Provider Information | |||||||||
| NPI: | 1780849869 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KNEIP | ||||||||
| FirstName: | RENEE | ||||||||
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| Credential: | O.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5045 | ||||||||
| Address2: | ATTN: PROV ENROLLMENT | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571175045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053226428 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4500 S PRINCE OF PEACE PL | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571035830 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053225600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2008 | ||||||||
| LastUpdateDate: | 06/21/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 0133 | SD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 1780849869 | 01 | BCBSMN | OTHER | 1780849869 | 01 | SD | WELLMARK BCBS; TRICARE | OTHER | 1780849869 | 05 | MN | MEDICAID | 10025846700 | 05 | NE | MEDICAID | 1780849869 | 05 | IA | MEDICAID | 9290501 | 01 | SD | DAKOTACARE | OTHER |