Active NPI
Jacqueline Schulte
- Physical Therapist
- Maryville, MO
National Provider Identifier
1417736786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2017027002
- Practice address
- 409 W South Hills Dr
Maryville, MO 64468-3639 - Phone
- (660) 562-7908
- NPI assigned
- Sep 26, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2017027002 | MO | Primary |
Addresses
Primary practice location
409 W South Hills Dr
Maryville, MO 64468-3639
Mailing address
34494 280TH St
Ravenwood, MO 64479-8159
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2017027002 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695686400000",
"number": "1417736786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34494 280TH ST",
"city": "RAVENWOOD",
"state": "MO",
"postal_code": "644798159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 W SOUTH HILLS DR",
"city": "MARYVILLE",
"state": "MO",
"postal_code": "644683639",
"telephone_number": "660-562-7908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHULTE",
"first_name": "JACQUELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-26",
"last_updated": "2023-09-26",
"certification_date": "2023-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2017027002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maryville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.