MARK THELEN (NPI# 1164414058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164414058 |
| Entity Type | Individual |
| Full Name | MARK THELEN |
| Credential | PT |
| Practice Address |
1061 Harmon Ave Ste 1d03 Fort Stewart GA 31314-5641 |
| Practice Telephone | 9124356780 |
| Mailing Telephone | 9124356780 |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2011-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
4300 | SC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568425908 | Mark R Thelen | Psychologist | 1930 Coon Rapids Blvd, Family Life Mental Health Center, Coon Rapids, MN 55433 | 2006-04-07 |
| Street Address |
1061 HARMON AVE STE 1D03 |
| City | FORT STEWART |
| State | GA |
| Zip Code | 31314-5641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750381570 | Deborah Greggs Loughney | Pharmacist | 1061 Harmon Ave Ste 1d03, Winn Army Community Hospital, Fort Stewart, GA 31314-5674 | 2005-07-22 |
| 1740710102 | Billie Niehoff | Registered Nurse | 1061 Harmon Ave Ste 1d03, Fort Stewart, GA 31314-5641 | 2017-06-18 |
| 1013378892 | Selina Marie Pooser | Physician Assistant | 1061 Harmon Ave Ste 1d03, Fort Stewart, GA 31314-5641 | 2016-03-08 |
| 1497128383 | Cheryl L Maddox | Military Health Care Provider | 1061 Harmon Ave Ste 1d03, Fort Stewart, GA 31314-5674 | 2015-11-02 |
| 1255712006 | Robert Lawrence IIi | General Practice | 1061 Harmon Ave Ste 1d03, Fort Stewart, GA 31314-5641 | 2015-06-17 |
| 1558753632 | Dallin Mitchell | General Practice | 1061 Harmon Ave Ste 1d03, Fort Stewart, GA 31314-5641 | 2015-02-25 |
| 1205230224 | Shaundra Robinson | Registered Nurse | 1061 Harmon Ave Ste 1d03, Bldg. 308, Fort Stewart, GA 31314-5641 | 2014-10-20 |
| 1851792436 | Michelle Bunting | Registered Nurse | 1061 Harmon Ave Ste 1d03, Fort Stewart, GA 31314-5641 | 2014-09-15 |
| 1124429709 | Sandra Tina Watkins | Licensed Practical Nurse | 1061 Harmon Ave Ste 1d03, Fort Stewart, GA 31314-5641 | 2014-09-15 |
| 1952702383 | Christine Willey Macko | Registered Nurse | 1061 Harmon Ave Ste 1d03, Fort Stewart, GA 31314-5641 | 2014-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932733995 | Heather Ziccarelli Deneen | Dietitian, Registered | 441 Bultman Ave, 1183, Fort Stewart, GA 31314 | 2020-02-28 |
| 1073099826 | Ross Emerick | Dentist | 351 West 6th Street, Fort Stewart, GA 31314 | 2018-07-16 |
| 1184154742 | Roland Garcia | Dentist | 351 W 6th St Bldg 440, Ft Stewart, GA 31314 | 2017-06-15 |
| 1548613045 | Sylvia Mclean | Dental Hygienist | 343 Vanguard Road, Fort Stewart, GA 31314 | 2016-07-20 |
| 1407209257 | David Wald Jr. | Dental Hygienist | 305 Vanguard Rd. Bldg 8335, Fort Stewar, GA 31314 | 2016-07-18 |
| 1376995415 | Alisha Potter | Dental Assistant | 305 Vangurard Road, Ft Stewart, GA 31314 | 2016-07-12 |
| 1538511068 | Brandi Harris | Dental Assistant | 305 Vanguard Rd, Ft Stewart, GA 31314 | 2016-07-08 |
| 1548612088 | Adrian Cuthbert | Dental Assistant | 305 Vanguard Road, Bldg 8435, Fort Stewart, GA 31314 | 2016-07-08 |
| 1841642386 | Beverly Lynn Berry | Dental Assistant | 306 Vanguard Road Bldg 8435, Fort Stewart, GA 31314 | 2016-07-08 |
| 1740630060 | Anjanette Nicole' Brown | Dental Assistant | 706 Warriors Rd, Building 2115, Fort Stewart, GA 31314 | 2016-06-17 |
| Find all providers in zip 31314 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770111270 | Kendal Padgett | Physical Therapist | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-30 |
| 1811988686 | Gary L Hall | Physical Therapist | 1061 Harmon Ave, Ste 1d03, Fort Stewart, GA 31314-5604 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871100479 | Production Physicos,llc | Physical Therapist | 461 Sandy Creek Rd Ste 1102, Fayetteville, GA 30214-4284 | 2020-09-28 |
| 1710593819 | David Spellings | Physical Therapist | 3991 Us-78, Suite 200, Snellville, GA 30039 | 2020-09-23 |
| 1841801644 | Noah Konner Lindsey | Physical Therapist | 5270 Peachtree Pkwy Ste 116, Norcross, GA 30092-2558 | 2020-08-14 |
| 1942810106 | Caitlin M Hesse | Physical Therapist | 4480 S Cobb Dr Se Ste Y, Smyrna, GA 30080-6984 | 2020-08-03 |
| 1669007316 | Dynamic Swing Performance, LLC | Physical Therapist | 2031 Cobblestone Cir Ne, Brookhaven, GA 30319-4909 | 2020-03-03 |
| 1356810113 | Ryan Daniel Ahlenius | Physical Therapist | 6360 Dove Dr, Loganville, GA 30052-3031 | 2018-11-21 |
| 1720557127 | Dr. Tiffany Lamonde LLC | Physical Therapist | 1445 Haw Creek Circle, Suite 503, Cumming, GA 30041 | 2018-11-15 |
| 1700363686 | Jason Y Kawamura | Physical Therapist | 2300 Liam Ave Ste 103, Dacula, GA 30019-2265 | 2018-07-24 |
| 1649766528 | Carrie Elizabeth Dendtler | Physical Therapist | 320 Montgomery Ave, Alpharetta, GA 30004-3163 | 2018-07-03 |
| 1558853085 | Re Generate Physiotherapy, LLC | Physical Therapist | 1240 Ga-54, Building 700, Fayetteville, GA 30214 | 2018-05-31 |
| Find all providers with the same taxonomy | ||||
| City | FORT STEWART |
| Zip Code | 31314 |
Please comment or provide details below to improve the information on MARK THELEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.