Active NPI
Gretchen Renae Schroer, DPT
- Physical Therapist
- Moline, IL
National Provider Identifier
1023340130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 004656
- Practice address
- 850 43Rd Ave Ste 100
Moline, IL 61265-8401 - Phone
- (309) 743-2070
- Fax
- (309) 743-2073
- NPI assigned
- Feb 1, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 004656 | IA | Primary |
| Physical Therapist | 225100000X | 070-018208 | IL |
Addresses
Primary practice location
850 43Rd Ave Ste 100
Moline, IL 61265-8401
Mailing address
3605 University Dr Ste 2
Muscatine, IA 52761-9607
Phone (563) 263-2639
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004656 | Other | IA | IOWA PT LICENSE |
Other names 1
- Gretchen Renae Spies
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 |
|---|---|---|---|
| 070-018208 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Home Town Physical Therapy, LLC | 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.
-
- Physical Therapy Clinic/Center
- Fairbanks, AK
- NPI 1366478935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390176000000",
"number": "1023340130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3605 UNIVERSITY DR STE 2",
"city": "MUSCATINE",
"state": "IA",
"postal_code": "527619607",
"telephone_number": "563-263-2639",
"fax_number": "563-263-2691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 43RD AVE STE 100",
"city": "MOLINE",
"state": "IL",
"postal_code": "612658401",
"telephone_number": "309-743-2070",
"fax_number": "309-743-2073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROER",
"first_name": "GRETCHEN",
"middle_name": "RENAE",
"name_prefix": "Ms.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-01",
"last_updated": "2014-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "004656",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-018208",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IOWA PT LICENSE",
"identifier": "004656",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GRETCHEN",
"last_name": "SPIES",
"middle_name": "RENAE",
"credential": "DPT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Moline, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.