Mary Jane Theiler, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1155 Issued in NE

Practice address

410 E 22ND St
Fremont, NE 68025-2609

Phone

(402) 721-3908

Fax

(402) 721-4047

NPI assigned

Nov 14, 2005

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

Other identifiers 2

Other names 1

• Mary Jane Rainforth Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• DPT Holdings PLLC

  • Physical Therapist
  • Plainfield, IL
  • NPI 1689648602
  NPD

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466812800000",
    "number": "1497737712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E 22ND ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252609",
            "telephone_number": "402-721-3908",
            "fax_number": "402-721-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEILER",
        "first_name": "MARY",
        "middle_name": "JANE",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2016-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0586347",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "6531",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "RAINFORTH",
            "middle_name": "JANE",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patricia Ann Terp, M.D.
• Ross M Tessendorf, DPT
• Amanda L. Tessmer
• Catherine Rae Thares
• The Climb Counseling Services LLC
• Angela Thompson
• Gage Robert Thompson, PHARMD
• Jodie Thompson
• Julie Marie Thompson
• Three Rivers Public Health Department

• Physical Therapist in Fremont, NE
• Providers in Fremont, NE by specialty
• Physical Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2016; 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.