Individual provider Active NPI

Doris A Thole, PT

  • Geriatric Physical Therapist
  • Belleville, IL
National Provider Identifier
1083182596
Registry record updated Nov 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
070-010391 Issued in IL
Practice address
1021 W E St
Belleville, IL 62220-1055
Phone
(618) 233-2095
NPI assigned
Nov 2, 2018
Last updated
Nov 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 070-010391 IL Primary

Addresses

Primary practice location

1021 W E St
Belleville, IL 62220-1055

Mailing address

2600 Compass Rd
Glenview, IL 60026-8001
Phone (618) 401-0671

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
070-010391ILMDGeriatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1083182596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 COMPASS RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268001",
            "telephone_number": "618-401-0671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 W E ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201055",
            "telephone_number": "618-233-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOLE",
        "first_name": "DORIS",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-02",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "IL",
            "license": "070-010391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; 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.