Elizabeth Jackstadt Theeman, MS, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

025769 Issued in NY

Practice address

39 Court St.
Plattsburgh, NY 12901

Phone

(518) 563-0267

Fax

(518) 563-1633

NPI assigned

Dec 28, 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 names 1

• Elizabeth N Jackstadt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

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.

• Champlain Valley Physicians Hospital Medical Center

  • Internal Medicine Physician
  • Plattsburgh, NY
  • NPI 1124189782
  NPD (past)
• Sports, Orthopedic and Spine Rehabilitation, P.T. P.C.

  • Physical Therapist
  • Plattsburgh, NY
  • NPI 1912991761
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1558348987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 COURT ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "12901",
            "telephone_number": "518-563-0267",
            "fax_number": "518-563-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 COURT ST.",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "12901",
            "telephone_number": "518-563-0267",
            "fax_number": "518-563-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEEMAN",
        "first_name": "ELIZABETH",
        "middle_name": "JACKSTADT",
        "name_prefix": "Ms.",
        "credential": "MS, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "JACKSTADT",
            "middle_name": "N",
            "credential": "M.S.P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rori Tetreault, LMSW
• TG Behavioral Health Consultants Inc.
• The Pathology Group PC
• The PH.WC LLP
• The Young Mens Christian Association of Plattsburgh, New York
• Thephwc LLP
• Katelyn Therrian, MSW
• Thomas G. Trudell, Inc.
• Thomas W Kneifel
• Thomas W Kneifel MD PLLC

• Physical Therapist in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.