Individual provider Active NPI

Tamara M Thiesen, PTA

  • Physical Therapy Assistant
  • Scribner, NE
National Provider Identifier
1023396751
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
759 Issued in NE
Practice address
815 Logan St
Scribner, NE 68057-3116
Phone
(402) 664-2389
Fax
(402) 664-2399
NPI assigned
Jul 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 759 NE Primary

Addresses

Primary practice location

815 Logan St
Scribner, NE 68057-3116

Mailing address

815 Logan St
Scribner, NE 68057-3116
Phone (402) 664-2389

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

State licenses

LicenseStateTypeSpecialty
759NEMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1023396751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 LOGAN ST",
            "city": "SCRIBNER",
            "state": "NE",
            "postal_code": "680573116",
            "telephone_number": "402-664-2389",
            "fax_number": "402-664-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 LOGAN ST",
            "city": "SCRIBNER",
            "state": "NE",
            "postal_code": "680573116",
            "telephone_number": "402-664-2389",
            "fax_number": "402-664-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIESEN",
        "first_name": "TAMARA",
        "middle_name": "M",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-29",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NE",
            "license": "759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scribner, 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.

Verify at the official NPI Registry.