Active NPI
Thaddeus R Liebig, PT, DPT,ATC
- Physical Medicine & Rehabilitation Physician
- Hartington, NE
National Provider Identifier
1023019544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 1668
- Practice address
- 401 W Darlene St
Hartington, NE 68739-4510 - Phone
- (402) 254-3985
- Fax
- (402) 254-3963
- NPI assigned
- Aug 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1065 | SD | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 1668 | NE | Primary |
Addresses
Primary practice location
401 W Darlene St
Hartington, NE 68739-4510
Mailing address
401 W Darlene St
PO Box 107
Hartington, NE 68739-4510
Phone (402) 254-3985
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5834080 | Medicaid | SD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1668 | NE | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311897600000",
"number": "1023019544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 W DARLENE ST",
"address_2": "PO BOX 107",
"city": "HARTINGTON",
"state": "NE",
"postal_code": "687394510",
"telephone_number": "402-254-3985",
"fax_number": "402-254-3963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 W DARLENE ST",
"city": "HARTINGTON",
"state": "NE",
"postal_code": "687394510",
"telephone_number": "402-254-3985",
"fax_number": "402-254-3963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBIG",
"first_name": "THADDEUS",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PT, DPT,ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-09",
"last_updated": "2011-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SD",
"license": "1065",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "NE",
"license": "1668",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5834080",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hartington, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.