Tomark Physicians PA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

TOMARK PHYSICIANS PA

Doing business as

Physicians Neck & Back Clinics

Practice address

158 19TH St S
Sartell, MN 56377

Phone

(320) 253-5385

Fax

(320) 253-5396

NPI assigned

Oct 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mark J Thibault, MD

Title

Owner

Phone

(320) 253-5385

Specialties & licenses 1

Addresses

Other names 1

• Physicians Neck & Back Clinics Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles E Kelly, MD

  • Specialist
  • Roseville, MN
  • NPI 1730123639
  NPD (past)
• Staci M Theisen, ATC

  • Athletic Trainer
  • Sartell, MN
  • NPI 1467739367
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1538259585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 19TH ST S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "56377",
            "telephone_number": "320-253-5385",
            "fax_number": "320-253-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 19TH ST S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "56377",
            "telephone_number": "320-253-5385",
            "fax_number": "320-253-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMARK PHYSICIANS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THIBAULT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-253-5385",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Neck & Back Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natalie Thyen, PT, DPT
• Jeffrey S. Tiahrt, PA-C
• Alissa Tillotson
• Alan L. Tims, M.D.
• Rebecca Tollefson, DDS
• Amanda Jo Totz
• Amber Traxler
• Abigail Tresco
• Preston Bailey Triemert
• Maia Frances Paulsen Trombley

• Physical Medicine & Rehabilitation Physician in Sartell, MN
• Providers in Sartell, MN by specialty
• Physical Medicine & Rehabilitation Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.