Kory David Tieman, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1627 4TH St
Peru, IL 61354-3507

Phone

(815) 223-4479

NPI assigned

Jun 9, 2020

Last updated

Sep 18, 2024By the provider in NPPES

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

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City Center Rehabilitation West - Inc.Group PAC ID 6901963164, 4 clinicians

Break Free Physical Therapy PLLCGroup PAC ID 2466837661, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Break Free Physical Therapy PLLC

  • Physical Therapist
  • Springfield, IL
  • NPI 1467189654
  Medicare reassignment Care Compare group NPD
• City Center Rehabilitation West - Inc.

  • Physical Therapy Clinic/Center
  • Peru, IL
  • NPI 1396981742
  Medicare reassignment Care Compare group NPD
• Carle West Physician Group Inc

  • Family Medicine Physician
  • Normal, IL
  • NPI 1467074138
  Medicare reassignment NPD
• Movement RX LLC

  • Physical Therapy Clinic/Center
  • La Salle, IL
  • NPI 1184458671
  NPD Authorized official
• City Center Physical Therapy - Peru, Inc.

  • Physical Therapist
  • Peru, IL
  • NPI 1043362965
  NPD (past)

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1376168005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 PARKSHORES DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617011439",
            "telephone_number": "815-830-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 4TH ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613543507",
            "telephone_number": "815-223-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEMAN",
        "first_name": "KORY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-09",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna J. Sweetland, M.D.
• Lori A Teverbaugh, M.D.
• The Visions Group, Inc. (Sterling Optical)
• Kendra Lenee Theodosopoulos, AU.D.
• Theos Audiology Solutions LLC
• Timothy J Mertes and Michael D Piller Partners (Mertes Piller Chiropractic)
• Mary Claire Tomminello
• Tricia Tonarelli
• Morgan Torman, LSW
• Terri Torres

• Physical Therapist in Peru, IL
• Providers in Peru, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.