Active NPI
Sara Davis Schalk, OD
- Optometrist
- Appleton, WI
National Provider Identifier
1275617300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2975
- Practice address
- 21 Park PL
Appleton, WI 54914-8872 - Phone
- (920) 739-4361
- NPI assigned
- Oct 25, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2975 | WI | Primary |
Addresses
Primary practice location
21 Park PL
Appleton, WI 54914-8872
Mailing address
21 Park PL
Appleton, WI 54914-8872
Phone (920) 739-4361
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2974 | Other | WI | LICENSE |
Other names 1
- Dr. Sara Jean Davis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2500 E Capitol Dr
Suite 3500
Appleton, WI 54911-8735
Phone (920) 358-1820
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2975 | WI | MD | Clinical Social Worker |
| 2853 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Eye Associates | Optometrist | Current | Accepting new patients |
| Park Place Optical, LTD | Past | Accepting new patients | |
| Wyoming Family Vision Care PLLC | Optometrist | Past | Accepting new patients |
| Luxottica of America Inc | Past | Accepting new patients | |
| Wyoming Family Vision Care LLC | Optometrist | Past | Accepting new patients |
Locations
21 Park Pl
Appleton, WI 54914
Phone (920) 739-4361
2500 E Capitol Dr
Ste 3500
Appleton, WI 54911
Phone (920) 358-1820
4648 W Spencer St
Appleton, WI 54914
Phone (920) 731-7557
Interoperability endpoints
- sschalk34881@direct.thedacare.org
Organizations & group practices 5
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.
-
- Optometrist
- Appleton, WI
- NPI 1699789032
-
- Optician
- Appleton, WI
- NPI 1255465738
-
- Eyewear Supplier
- Kansas City, MO
- NPI 1497412522
-
- Optometrist
- Wyoming, MI
- NPI 1730583972
-
- Optometrist
- Wyoming, MI
- NPI 1922206531
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364256000000",
"number": "1275617300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 PARK PL",
"city": "APPLETON",
"state": "WI",
"postal_code": "549148872",
"telephone_number": "920-739-4361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 PARK PL",
"city": "APPLETON",
"state": "WI",
"postal_code": "549148872",
"telephone_number": "920-739-4361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHALK",
"first_name": "SARA",
"middle_name": "DAVIS",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2013-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "2975",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "2974",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SARA",
"last_name": "DAVIS",
"middle_name": "JEAN",
"prefix": "DR.",
"credential": "OD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.