Active NPI
Amy Susanne Thiessen
- Physical Therapist
- Oklahoma City, OK
National Provider Identifier
1174770226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT2694
- Practice address
- 820 NE 15TH St
Oklahoma City, OK 73104-4602 - Phone
- (405) 271-6242
- Fax
- (405) 271-2887
- NPI assigned
- Aug 20, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT2694 | OK | Primary |
Addresses
Primary practice location
820 NE 15TH St
Oklahoma City, OK 73104-4602
Mailing address
820 NE 15TH St
Oklahoma City, OK 73104-4602
Phone (405) 271-6242
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 |
|---|---|---|---|
| 2694 | OK | MD | Professional Counselor |
| PT2694 | OK | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413849600000",
"number": "1174770226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 NE 15TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731044602",
"telephone_number": "405-271-6242",
"fax_number": "405-271-2887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 NE 15TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731044602",
"telephone_number": "405-271-6242",
"fax_number": "405-271-2887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIESSEN",
"first_name": "AMY",
"middle_name": "SUSANNE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-20",
"last_updated": "2014-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "PT2694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.