Active NPI
Joan Marie Schultz, COTA
- Skilled Nursing Facility
- Sheboygan, WI
National Provider Identifier
1235346362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 1801968847
- Practice address
- 3014 Erie Ave
Sheboygan, WI 53081-3658 - Phone
- (920) 453-7049
- Fax
- (920) 459-4341
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1801968847 | WI | Primary |
Addresses
Primary practice location
3014 Erie Ave
Sheboygan, WI 53081-3658
Mailing address
2130 N 20TH St
Sheboygan, WI 53081-2213
Phone (920) 453-7049
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 118-027 | Other | WI | CERIFIED OT ASSISTANT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1801968847 | WI | MD | Skilled Nursing Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235346362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2130 N 20TH ST",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530812213",
"telephone_number": "920-453-7049",
"fax_number": "920-459-4341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3014 ERIE AVE",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530813658",
"telephone_number": "920-453-7049",
"fax_number": "920-459-4341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHULTZ",
"first_name": "JOAN",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WI",
"license": "1801968847",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERIFIED OT ASSISTANT",
"identifier": "118-027",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.