Individual provider Active NPI

Grant Schultes

  • Physical Therapist
  • Lincoln, NE
National Provider Identifier
1124419130
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4742 Issued in NE
Practice address
4130 Pioneer Woods Dr Ste 3
Lincoln, NE 68506-7552
Phone
(402) 261-6841
Fax
(402) 261-6843
NPI assigned
Feb 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 073868 IA
Physical Therapist 225100000X 4742 NE Primary

Addresses

Primary practice location

4130 Pioneer Woods Dr Ste 3
Lincoln, NE 68506-7552

Mailing address

4130 Pioneer Woods Dr Ste 3
Lincoln, NE 68506-7552
Phone (402) 261-6841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250630001286 NE Practitioner - Physical Therapist in Private Practice 1355854746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4130 Pioneer Woods Dr
Suite 3
Lincoln, NE 68506-7552
Phone (402) 261-6841

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
073868IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spine & Sports Physical Therapy LLC CurrentSince Mar 15, 2025 Accepting new patients

Locations

4130 Pioneer Woods Dr
Ste 3
Lincoln, NE 68506
Phone (402) 261-6841

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1124419130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 PIONEER WOODS DR STE 3",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067552",
            "telephone_number": "402-261-6841",
            "fax_number": "402-261-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 PIONEER WOODS DR STE 3",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067552",
            "telephone_number": "402-261-6841",
            "fax_number": "402-261-6843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTES",
        "first_name": "GRANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-12",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "073868",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "4742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.