Derek Anton Schildknecht, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1344860 Issued in TX

Practice address

1014 Business Park Dr Ste a
Hailey, ID 83333-5233

Phone

(208) 788-6312

Fax

(208) 578-1053

NPI assigned

May 29, 2018

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

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Luna Care Physical Therapy LLCGroup PAC ID 0648692723, 271 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Texas Luna Care Physical Therapy LLC

  • Physical Therapist
  • Southlake, TX
  • NPI 1790309656
  Medicare reassignment Care Compare group NPD
• Baylor College of Medicine

  • Ph.D. Medical Genetics
  • Houston, TX
  • NPI 1881026664

  TX

  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1366933178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 SETON CENTER PKWY",
            "address_2": "STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594107",
            "telephone_number": "512-439-1000",
            "fax_number": "512-439-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 BUSINESS PARK DR STE A",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833335233",
            "telephone_number": "208-788-6312",
            "fax_number": "208-578-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILDKNECHT",
        "first_name": "DEREK",
        "middle_name": "ANTON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-29",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1344860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• S & M, Inc.
• Safe Haven Health Care LLC
• Sawtooth Periodontics PLLC
• David Louis Schenkar, MD
• Jeff Sutton Schetter, HAD
• Amy Schlatter
• Carrie Thomas Scott, LCPC
• Glen David Shapiro, MD
• Randye Sue Simcoe, RPH
• Smiles 4 Kids Hailey

• All providers in Hailey, ID
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.