Individual provider Active NPI

Shonda Thiess

  • Physical Therapy Assistant
  • Hudson, WI
National Provider Identifier
1487000352
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2366 Issued in WI
Practice address
421 Locust St
Hudson, WI 54016-1619
Phone
(715) 441-4596
Fax
(414) 327-5411
NPI assigned
May 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2366 WI Primary

Addresses

Primary practice location

421 Locust St
Hudson, WI 54016-1619

Mailing address

421 Locust St
Hudson, WI 54016-1619
Phone (715) 441-4596

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1487000352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 LOCUST ST",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540161619",
            "telephone_number": "715-441-4596",
            "fax_number": "414-327-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 LOCUST ST",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540161619",
            "telephone_number": "715-441-4596",
            "fax_number": "414-327-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIESS",
        "first_name": "SHONDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-10",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.