NPIMap

Individual provider Active NPI

Danielle R Thiessen, DPT

  • Pediatric Physical Therapist
  • Papillion, NE
National Provider Identifier
1013140565
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
2815 Issued in NE
Practice address
10601 S 72ND St Ste 103
Papillion, NE 68046-3408
Phone
(402) 932-2782
Fax
(402) 932-2705
NPI assigned
Sep 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 2815 NE Primary

Addresses

Primary practice location

10601 S 72ND St Ste 103
Papillion, NE 68046-3408

Mailing address

10601 S 72ND St Ste 103
Papillion, NE 68046-3408
Phone (402) 932-2782

Other names 1

  • Danielle R Wyant Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Center Pediatrics PastSince Mar 22, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1013140565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10601 S 72ND ST STE 103",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680463408",
            "telephone_number": "402-932-2782",
            "fax_number": "402-932-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10601 S 72ND ST STE 103",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680463408",
            "telephone_number": "402-932-2782",
            "fax_number": "402-932-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIESSEN",
        "first_name": "DANIELLE",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-01",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NE",
            "license": "2815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "WYANT",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.

Verify at the official NPI Registry.