Keith David Schroeder

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070011507 Issued in IL

Practice address

400 E 4TH St
Beardstown, IL 62618-1307

Phone

(217) 323-7006

NPI assigned

Dec 10, 2024

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

• Beardstown Therapy Clinic

  • Physical Therapist
  • Beardstown, IL
  • NPI 1700596442
  NPD

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

{
    "created_epoch": "1733788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1295541571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 4TH ST",
            "city": "BEARDSTOWN",
            "state": "IL",
            "postal_code": "626181307",
            "telephone_number": "217-323-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 4TH ST",
            "city": "BEARDSTOWN",
            "state": "IL",
            "postal_code": "626181307",
            "telephone_number": "217-323-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "KEITH",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-10",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070011507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Rolf, MA QMHP
• Jenna Marie Rossi, BS, MHP
• Sai RX Mart, LLC
• Ashley Sanders, MHP
• Kimberly Sandoval, RSA
• Schuyler County Hospital District
• Schuyler County Hospital District
• Schuyler County Hospital District
• Schuyler County Hospital District Health Center Inc
• Schuyler County Hospital District Health Center Inc.

• Physical Therapist in Beardstown, IL
• Providers in Beardstown, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.