Edwin Barclay Shultz, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27416 Issued in WI

Practice address

112 Helen St
Sauk City, WI 53583-1101

Phone

(608) 643-3351

Fax

(608) 643-3621

NPI assigned

Sep 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: e.shultzmd.p1@direct.prairieclinic.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Sauk Prairie Healthcare, Inc.

  dba Prairie Clinic

  • Family Medicine Physician
  • Sauk City, WI
  • NPI 1235163494
  Medicare reassignment NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316045099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HELEN ST",
            "city": "SAUK CITY",
            "state": "WI",
            "postal_code": "535831101",
            "telephone_number": "608-643-3351",
            "fax_number": "608-643-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HELEN ST",
            "city": "SAUK CITY",
            "state": "WI",
            "postal_code": "535831101",
            "telephone_number": "608-643-3351",
            "fax_number": "608-643-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTZ",
        "first_name": "EDWIN",
        "middle_name": "BARCLAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "27416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30699000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Todd A Schad, M.D.
• Joanna K Schindler, OTR
• Maureen Ann Schlager, RN CDE
• Vanessa Schoenherr
• Kelly M Sherwood, SPEECH PATHOLOGIST
• Paige Barri Sisbach, NP-BC
• Glenna Spears, CNM
• Sport & Spine Clinic of Fort Atkinson Limited Partnership
• Debra A Steuck, R.PH.
• Rita A Tafs, APNP

• Family Medicine Physician in Sauk City, WI
• Providers in Sauk City, WI by specialty
• Family Medicine Physician in Wisconsin

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.