Individual provider Active NPI

Ryan Schott

  • Physical Therapist
  • Southport, NC
National Provider Identifier
1215657523
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP049812T Issued in NC
Practice address
4002 Executive Park Blvd Ste 800
Southport, NC 28461-9069
Phone
(910) 477-6326
NPI assigned
Aug 29, 2022
Last updated
Sep 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT42722 FL
Physical Therapist 225100000X CP049812T NC Primary
Physical Therapist 225100000X 2305215378 VA

Addresses

Primary practice location

4002 Executive Park Blvd Ste 800
Southport, NC 28461-9069

Mailing address

625 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-2395

Other practice location 1

11800 Sunrise Valley Dr Ste 1
Reston, VA 20191-5302
Phone (540) 645-7149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221201001818 DC Practitioner - Physical Therapist in Private Practice 4880062413 Reassigns benefits to 1 organization
I20260105000194 NC Practitioner - Physical Therapist in Private Practice 4880062413 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Performance Sports and Physical Therapy LLCGroup PAC ID 0749276426, 60 clinicians
Change the Game Performance Therapy IncGroup PAC ID 6406380203, 6 clinicians

Practice addresses (Care Compare)

4002 Executive Park Blvd
Suite 800
Southport, NC 28461-9069
Phone (910) 477-6326

805 N 4TH St
Suite D
Wilmington, NC 28401-3472
Phone (910) 915-4888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT42722FLMDPhysical Therapist
CP049812TNCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Performance Sports and Physical Therapy, LLC Physical Therapist CurrentSince Oct 14, 2025 Accepting new patients
Change the Game Performance Therapy, Inc. Physical Therapist CurrentSince Nov 13, 2025 Accepting new patients
Carolina Strong Physical Therapy, LLC Physical Therapist CurrentSince Sep 28, 2025 Accepting new patients

Locations

625 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546

2009 Neuse Blvd
New Bern, NC 28560
Phone (252) 636-9800

292 Commerce Ave
Southern Pnes, NC 28387
Phone (910) 757-0408

4002 Executive Park Blvd
Ste 800
Southport, NC 28461
Phone (910) 357-5748

805 N 4th St
Wilmington, NC 28401
Phone (315) 292-8976

805 N 4th St
Ste D
Wilmington, NC 28401
Phone (910) 915-4888

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1215657523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 EXECUTIVE PARK BLVD STE 800",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284619069",
            "telephone_number": "910-477-6326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11800 Sunrise Valley Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Reston",
            "state": "VA",
            "postal_code": "201915302",
            "country_code": "US",
            "telephone_number": "540-645-7149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHOTT",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-29",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT42722",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "CP049812T",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215378",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.