Individual provider Active NPI

Mary Hensleigh Thane, PT, GCS

  • Geriatric Physical Therapist
  • Missoula, MT
National Provider Identifier
1730869579
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
519 Issued in MT
Practice address
2827 Fort Missoula Rd
Missoula, MT 59804-7408
Phone
(406) 327-4050
Fax
(406) 327-4566
NPI assigned
Jul 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 519 MT
Geriatric Physical Therapist 2251G0304X 519 MT Primary

Addresses

Primary practice location

2827 Fort Missoula Rd
Missoula, MT 59804-7408

Mailing address

604 W Artemos Dr
Missoula, MT 59803-1504
Phone (406) 214-1917

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

State licenses

LicenseStateTypeSpecialty
519MTMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1730869579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 W ARTEMOS DR",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598031504",
            "telephone_number": "406-214-1917",
            "fax_number": "406-327-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2827 FORT MISSOULA RD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047408",
            "telephone_number": "406-327-4050",
            "fax_number": "406-327-4566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANE",
        "first_name": "MARY",
        "middle_name": "HENSLEIGH",
        "credential": "PT, GCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "519",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "MT",
            "license": "519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.