Active NPI
John A Schroeder, PT
- Physical Therapist
- Federal Way, WA
National Provider Identifier
1316086523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00002989
- Practice address
- 33501 1St Way S
Federal Way, WA 98003-6208 - Phone
- (253) 838-2400
- NPI assigned
- Feb 5, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00002989 | WA | Primary |
| Athletic Trainer | 2255A2300X | PT00002989 | WA |
Addresses
Primary practice location
33501 1St Way S
Federal Way, WA 98003-6208
Mailing address
1100 Olive Way MSC M4-PA
Seattle, WA 98101-1873
Phone (206) 515-5811
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00106512 | Other | WA | RAILROAD MEDICARE |
| US1048093 | Other | WA | AETNA SPECIALIST PIN |
| 0035985 | Other | WA | LABOR AND INDUSTRIES # |
| SC2140 | Other | WA | BLUE SHIELD # |
| 8385718 | Medicaid | WA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00002989 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207612800000",
"number": "1316086523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 OLIVE WAY MSC M4-PA",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981011873",
"telephone_number": "206-515-5811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33501 1ST WAY S",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980036208",
"telephone_number": "253-838-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROEDER",
"first_name": "JOHN",
"middle_name": "A",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-05",
"last_updated": "2008-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00002989",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WA",
"license": "PT00002989",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00106512",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA SPECIALIST PIN",
"identifier": "US1048093",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES #",
"identifier": "0035985",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD #",
"identifier": "SC2140",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8385718",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Federal Way, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.