Kevin James Tielens, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12311-024 Issued in WI

Practice address

3021 Voyager Dr
Green Bay, WI 54311-8303

Phone

(920) 496-4700

NPI assigned

May 22, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1891132445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3875 CONARD RD",
            "city": "NEW FRANKEN",
            "state": "WI",
            "postal_code": "542299743",
            "telephone_number": "920-621-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 VOYAGER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118303",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3263 Eaton Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543116830",
            "country_code": "US",
            "telephone_number": "920-433-6700",
            "fax_number": "920-433-6709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIELENS",
        "first_name": "KEVIN",
        "middle_name": "JAMES",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-22",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12311-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktielens299853@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "3021 Voyager Dr",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543118303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Veronica Thomson
• Alicia L Thone, PT, DPT
• Thomas L Thoune, CSAC
• Thriveworks Clinical - Wisconsin
• Michael Arno Thurk, SAC
• Cynthia Leigh Tiesling, MSW, LCSW
• Carrie Lynn Tilkens, RPH
• Megan Timm, LICSW, LCSW
• Richard J Timmons, M.D.
• Maxime Tindong, MD

• Physical Therapist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.