Colleen Elizabeth Theissen

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

14749

Practice address

13825 Hunton LN
Huntersville, NC 28078-6190

Phone

(704) 897-2700

NPI assigned

Mar 16, 2023

Sex

Female

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": "1678924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1457052383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5021 ERICKSON RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13825 HUNTON LN",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786190",
            "telephone_number": "704-897-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEISSEN",
        "first_name": "COLLEEN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-16",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": "14749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Huntersville, NC
• Occupational Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.