Individual provider Active NPI

Danny Schroeder, PT

  • Physical Therapist
  • Peoria, IL
National Provider Identifier
1518217470
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070019293 Issued in IL
Practice address
6000 N Allen Rd
Peoria, IL 61614-3294
Phone
(309) 691-1400
Fax
(309) 693-3197
NPI assigned
Sep 18, 2012
Last updated
Aug 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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 070019293 IL Primary

Addresses

Primary practice location

6000 N Allen Rd
Peoria, IL 61614-3294

Mailing address

6000 N Allen Rd
Peoria, IL 61614-3294
Phone (309) 691-1400

Other practice location 1

2351 Broadway St
Pekin, IL 61554-3972
Phone (309) 691-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121017000248 IL Practitioner - Physical Therapist in Private Practice 1850541475 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Orthopaedic Center S CGroup PAC ID 8022917715, 45 clinicians

Practice addresses (Care Compare)

6000 N Allen Rd
Peoria, IL 61614-3294
Phone (309) 691-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070019293ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Il LLC Physical Therapist CurrentSince Jan 1, 2022 Accepting new patients
Revolution PTWL LLC Physical Therapist CurrentSince Nov 25, 2015 Accepting new patients
Midwest Orthopaedic Center S C CurrentSince Aug 15, 2022 Accepting new patients

Locations

845 N Michigan Ave
Ste 973W
Chicago, IL 60611
Phone (312) 651-6255

2351 Broadway St
Pekin, IL 61554
Phone (309) 353-4159

6000 N Allen Rd
Peoria, IL 61614
Phone (309) 391-1400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1518217470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 N ALLEN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143294",
            "telephone_number": "309-691-1400",
            "fax_number": "309-693-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 N ALLEN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143294",
            "telephone_number": "309-691-1400",
            "fax_number": "309-693-3197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2351 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Pekin",
            "state": "IL",
            "postal_code": "615543972",
            "country_code": "US",
            "telephone_number": "309-691-1400",
            "fax_number": "309-693-3197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "DANNY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-18",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070019293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; 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.