Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacey Jo Wenner

Individual provider Pediatric Occupational Therapist · NPI 1225760804

Jacey Jo Wenner is an Occupational Therapist in Private Practice in Saint Peter, Minnesota. Qualified in 2022, 4 years ago. Practices with Odom Sports Medicine PA, a 69-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2022
Specialties on file
2

Practice location Address checks out

830 Sunrise Dr Ste B
Saint Peter, MN 56082-1203
Phone: (507) 935-3573
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 106966 (MN)
Pediatric Occupational Therapist Taxonomy 225XP0200X · Licence 5937 (MN)

Record details

NPI number1225760804
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 30, 2022
Last updated in NPPESJuly 1, 2025
Certification dateJuly 1, 2025
Mailing address830 Sunrise Dr Ste B, Saint Peter, MN 56082-1203

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Odom Sports Medicine Pa — 69 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount