Individual provider Active NPI

Theresa Susan Schulze, COTA

  • Occupational Therapy Assistant
  • New London, WI
National Provider Identifier
1669886859
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
494427 Issued in WI
Practice address
107 E Beckert Rd
New London, WI 54961-2509
Phone
(920) 982-5354
NPI assigned
Jun 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 494427 WI Primary

Addresses

Primary practice location

107 E Beckert Rd
New London, WI 54961-2509

Mailing address

N1590 Erdine LN
Hortonville, WI 54944-8412
Phone (920) 475-4659

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
494427WIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1669886859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N1590 ERDINE LN",
            "city": "HORTONVILLE",
            "state": "WI",
            "postal_code": "549448412",
            "telephone_number": "920-475-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E BECKERT RD",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549612509",
            "telephone_number": "920-982-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULZE",
        "first_name": "THERESA",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "494427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; 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.