Anthony Schupp, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070016473 Issued in IL

Practice address

209 N Cummings LN
Washington, IL 61571-2181

Phone

(309) 886-2305

Fax

(309) 444-3893

NPI assigned

Jul 8, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Washington University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Therapy Services IncGroup PAC ID 0345145843, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Professional Therapy Services, Inc

  • Physical Therapist
  • Pekin, IL
  • NPI 1578615225
  Medicare reassignment Care Compare group NPD
• Professional Therapy Services

  • Speech-Language Pathologist
  • Peoria, IL
  • NPI 1194329060
  NPD (past)

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306454400000",
    "number": "1144483249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 N CUMMINGS LN",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615712181",
            "telephone_number": "309-886-2305",
            "fax_number": "309-444-3893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 N CUMMINGS LN",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615712181",
            "telephone_number": "309-886-2305",
            "fax_number": "309-444-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPP",
        "first_name": "ANTHONY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2011-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070016473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P00918646",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsie Schlueter, RN, BSN, IBCLC
• Ryan Daniel Schmidgall, M.D.
• Josey Renee Schouweiler, LCSW
• Amanda Ruth Schultz, PT
• Amber M Schupp, SLP
• Tara Seger, PTA
• Barbara Selden, M.S.
• Shelly Shallat
• Marcy Short, SLP
• Christina Showalter

• Physical Therapist in Washington, IL
• Providers in Washington, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; 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.