Active NPI
Mikelle J Thiele, PT
- Physical Therapist
- Tucson, AZ
National Provider Identifier
1811451750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 30480
- Practice address
- 7483 E Tanque Verde Rd
Tucson, AZ 85715-3477 - Phone
- (520) 207-7220
- Fax
- (520) 207-7109
- NPI assigned
- Jan 24, 2019
- Last updated
- Feb 5, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 30480 | AZ | Primary |
Addresses
Primary practice location
7483 E Tanque Verde Rd
Tucson, AZ 85715-3477
Mailing address
1106 Walnut St Ste 110
San Luis Obispo, CA 93401-2416
Phone (805) 788-0805
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30480 | AZ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athlon Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Movement For Life Physical Therapy
- Physical Therapy Clinic/Center
- Tucson, AZ
- NPI 1245449909
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549324800000",
"number": "1811451750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1106 WALNUT ST STE 110",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012416",
"telephone_number": "805-788-0805",
"fax_number": "805-788-0845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7483 E TANQUE VERDE RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857153477",
"telephone_number": "520-207-7220",
"fax_number": "520-207-7109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIELE",
"first_name": "MIKELLE",
"middle_name": "J",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-24",
"last_updated": "2019-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "30480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
- Therapeutic Riding of Tucson (TROT Therapy Services)
- Therapy Group of Tucson, LLC (Odyssey Autism ABA Therapy)
- Theratrics, Inc. (Theratrics)
- Nicole Andrea Thexton, CRT, RRT
- Sasha Anika Thiel
- Cynthia Marie Thiem, FNP-BC, MSN
- Deborah Thieme, CNA
- Ole Thienhaus, MD
- Kimberly Thiessen, PSYD
- Thili N Kulatilake MD, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.