Individual provider Active NPI

Gregory Thielen, OTR

  • Hand Occupational Therapist
  • Corvallis, OR
National Provider Identifier
1306221510
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
914584 Issued in OR
Practice address
2797 NW 9TH St
Corvallis, OR 97330-3857
Phone
(541) 207-0910
NPI assigned
Jul 29, 2015
Last updated
Jul 29, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 914584 OR Primary

Addresses

Primary practice location

2797 NW 9TH St
Corvallis, OR 97330-3857

Mailing address

2797 NW 9TH St
Corvallis, OR 97330-3857
Phone (541) 207-0910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151201000757 OR Practitioner - Occupational Therapist in Private Practice 8022207620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upper Hand Orthopaedics PCGroup PAC ID 1355592890, 5 clinicians

Practice addresses (Care Compare)

2797 NW 9TH St
Corvallis, OR 97330-3857
Phone (541) 207-0910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
914584ORMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Hand Orthopaedics, P.C. CurrentSince Oct 1, 2015 Accepting new patients

Locations

2773 NW 9th St
Corvallis, OR 97330
Phone (541) 207-0910

2797 NW 9th St
Corvallis, OR 97330
Phone (541) 207-0910

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5569/brand/1/csg/1/fhir/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1306221510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2797 NW 9TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303857",
            "telephone_number": "541-207-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2797 NW 9TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303857",
            "telephone_number": "541-207-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIELEN",
        "first_name": "GREGORY",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-29",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "OR",
            "license": "914584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.