Ethan Schultz, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16813-24 Issued in WI

Practice address

2815 New Pinery Rd
Portage, WI 53901-9257

Phone

(608) 745-6420

NPI assigned

Jun 4, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Divine Savior Healthcare, Inc.

  • General Acute Care Hospital
  • Portage, WI
  • NPI 1124083894

  Single Specialty

  Medicare reassignment NPD
• Divine Savior Healthcare, Inc.

  • Rural Health Clinic/Center
  • Portage, WI
  • NPI 1386154417
  NPD

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1285475103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017C PARKSIDE AVE APT 102",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539138979",
            "telephone_number": "320-894-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019257",
            "telephone_number": "608-745-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "ETHAN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16813-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Savoy, A.B.O.C.
• Lindsay Kay Schehr, NP
• Kristine G Schmitt, MA, LPC
• Bradley K Schnee, MD
• Rebecca Lynn Schomin, MOT
• Jonathan J Schulz, MSE
• Lori A Schumann, PT
• Service Drugs
• Seubert Family Dentistry, LLC
• Jan L Seubert, DDS

• Physical Therapist in Portage, WI
• Providers in Portage, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.