Individual provider Active NPI

Carly Schneeberg, DPT

  • Physical Therapist
  • West Allis, WI
National Provider Identifier
1154763316
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12083-24 Issued in WI
Practice address
5301 W Lincoln Ave
West Allis, WI 53219-1652
Phone
(414) 615-7146
NPI assigned
Jul 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12083-24 WI Primary

Addresses

Primary practice location

5301 W Lincoln Ave
West Allis, WI 53219-1652

Mailing address

5301 W Lincoln Ave
West Allis, WI 53219-1652

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190917000656 WI Practitioner - Physical Therapist in Private Practice 8123357159 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12083-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Physical Therapy & Sports Rehab, LLC CurrentSince Jun 14, 2021 Accepting new patients
Fox Rehabilitation Services Wi LLC Physical Therapist CurrentSince Aug 1, 2019 Accepting new patients
Advantage Physical Therapy & Sports Rehab, LLC Current Accepting new patients
Advantage Physical Therapy & Sports Rehab, LLC CurrentSince Jun 14, 2021 Accepting new patients
Advantage Physical Therapy & Sports Rehab, LLC Past Accepting new patients
Advantage PT & Sports Rehab LLC Past Accepting new patients
Advantage PT & Sports Rehab LLC Past Accepting new patients
Advantage Physical Therapy & Sports Rehab, LLC Past Accepting new patients
Comprehensive Orthopaedics SC Physical Therapist Past Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

204 S Pine St
Burlington, WI 53105
Phone (262) 767-9579

10222 74th St
Ste 211
Kenosha, WI 53142
Phone (262) 925-5020

5024 Green Bay Rd
Kenosha, WI 53144
Phone (262) 925-0200

7200 Washington Ave
Ste 104
Mount Pleasant, WI 53406
Phone (262) 583-0790

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 9

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": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1154763316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532191652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532191652",
            "telephone_number": "414-615-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEEBERG",
        "first_name": "CARLY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-29",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12083-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.