Mary Ann Schroeder, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2373-19 Issued in WI

Practice address

1625 E Main St
Clintonville, WI 54929-8407

Phone

(715) 823-3135

NPI assigned

Sep 20, 2018

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1598249013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W4978 PORTER RD",
            "city": "BONDUEL",
            "state": "WI",
            "postal_code": "541078805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 E MAIN ST",
            "city": "CLINTONVILLE",
            "state": "WI",
            "postal_code": "549298407",
            "telephone_number": "715-823-3135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 W Green Tree Rd",
            "address_purpose": "LOCATION",
            "city": "Clintonville",
            "state": "WI",
            "postal_code": "549291009",
            "country_code": "US",
            "telephone_number": "715-823-2194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2373-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Clintonville, WI
• Providers in Clintonville, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.