Individual provider Active NPI

Austin Theodore Schmitt, PT, DPT, LAT, ATC

  • Sports Physical Therapist
  • Green Bay, WI
National Provider Identifier
1073398012
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
17242-24 Issued in WI
Practice address
1265 Lombardi Ave
Green Bay, WI 54304-3927
Phone
(920) 569-7500
NPI assigned
Aug 28, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 3261-39 WI
Sports Physical Therapist 2251S0007X 17242-24 WI Primary

Addresses

Primary practice location

1265 Lombardi Ave
Green Bay, WI 54304-3927

Mailing address

2100 Holmgren Way Unit 111
Green Bay, WI 54304-4649
Phone (320) 226-7684

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17242-24WIMDSports Physical Therapist
3261-39WIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1073398012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 HOLMGREN WAY UNIT 111",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044649",
            "telephone_number": "320-226-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 LOMBARDI AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543043927",
            "telephone_number": "920-569-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMITT",
        "first_name": "AUSTIN",
        "middle_name": "THEODORE",
        "credential": "PT, DPT, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "3261-39",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "WI",
            "license": "17242-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.