Individual provider Active NPI

Tamra Schneider, PT

  • Physical Therapist
  • De Pere, WI
National Provider Identifier
1386884690
Registry record updated Feb 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6183-024 Issued in WI
Practice address
1142 Orlando Dr
De Pere, WI 54115-9484
Phone
(920) 339-0700
Fax
(920) 330-0278
NPI assigned
Feb 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6183-024 WI Primary

Addresses

Primary practice location

1142 Orlando Dr
De Pere, WI 54115-9484

Mailing address

446 Edgewood Dr
Green Bay, WI 54302-4873

Other identifiers 1

IdentifierTypeStateIssuer
40313300MedicaidWI

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6183-024WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235606400000",
    "number": "1386884690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 EDGEWOOD DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543024873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1142 ORLANDO DR",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159484",
            "telephone_number": "920-339-0700",
            "fax_number": "920-330-0278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "TAMRA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-26",
        "last_updated": "2009-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "6183-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40313300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in De Pere, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2009; 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.