Craig Leslie Thielen, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

00910 Issued in IA

Practice address

1731 W Ridgeway Ave
Suite 600
Waterloo, IA 50701-4594

Phone

(319) 833-5900

Fax

(319) 833-5901

NPI assigned

May 19, 2006

Last updated

Jul 1, 2014By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1942254719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2758",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042758",
            "telephone_number": "319-833-5900",
            "fax_number": "319-833-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 W RIDGEWAY AVE",
            "address_2": "SUITE 600",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507014594",
            "telephone_number": "319-833-5900",
            "fax_number": "319-833-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIELEN",
        "first_name": "CRAIG",
        "middle_name": "LESLIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "00910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK INS PLAN",
            "identifier": "17334",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0492272",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.