Mark Thelen, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

4300 Issued in SC

Practice address

1061 Harmon Ave Ste 1D03
Fort Stewart, GA 31314-5641

Phone

(912) 435-6780

NPI assigned

Aug 17, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296172800000",
    "number": "1164414058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE STE 1D03",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE STE 1D03",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THELEN",
        "first_name": "MARK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2011-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "SC",
            "license": "4300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Amanda Taylor-Racinelli, PA-C
• Graham Taylor, PA-C
• Robert Taylor, MEDIC
• Baxter Dixon Tharin, M.D.
• The Village of Sacred Melanin
• Cynthia L Thomas-Smith, R.N.
• Joshua Thomas, DMD
• Kelly Denise Thomas, MD
• Lorn Regan Thomas
• Peter Thomas, O.D.

• Orthopedic Physical Therapist in Fort Stewart, GA
• Providers in Fort Stewart, GA by specialty
• Orthopedic Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.