Individual provider Active NPI

Ian Schneider

  • Occupational Therapy Assistant
  • Newport, VT
National Provider Identifier
1124507033
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
073.0900339PROV Issued in VT
Practice address
35 Bel Aire Dr
Newport, VT 05855-4953
Phone
(802) 334-2878
NPI assigned
Aug 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 009819 NY
Occupational Therapy Assistant 224Z00000X 073.0900339PROV VT Primary
Occupational Therapy Assistant 224Z00000X OTP-OTA-LIC-6122 MT

Addresses

Primary practice location

35 Bel Aire Dr
Newport, VT 05855-4953

Mailing address

1158 N Country Club Dr
Niskayuna, NY 12309-5406
Phone (406) 419-8549

Other identifiers 2

IdentifierTypeStateIssuer
1124507033MedicaidMT
1124507033MedicaidNY

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
009819NYMDOptician
OTP-OTA-LIC-6122MTMDOccupational Therapy Assistant
073.0900339PROVVTMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1124507033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1158 N COUNTRY CLUB DR",
            "city": "NISKAYUNA",
            "state": "NY",
            "postal_code": "123095406",
            "telephone_number": "406-419-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 BEL AIRE DR",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058554953",
            "telephone_number": "802-334-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "IAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-10",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "009819",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VT",
            "license": "073.0900339PROV",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MT",
            "license": "OTP-OTA-LIC-6122",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124507033",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124507033",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.