Individual provider Active NPI

Jessica Lea Schroeder, DPT

  • Physical Therapist
  • Coralville, IA
National Provider Identifier
1720376627
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070020795 Issued in IL
Practice address
2854 Coral CT Ste 1
Coralville, IA 52241-2809
Phone
(319) 259-6224
NPI assigned
Jul 13, 2011
Last updated
Jan 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 23678 MD
Physical Therapist 225100000X 070020795 IL Primary

Addresses

Primary practice location

2854 Coral CT Ste 1
Coralville, IA 52241-2809

Mailing address

8434 Corcoran Rd
Willow Springs, IL 60480-1666
Phone (708) 467-0657

Other practice location 1

8434 Corcoran Rd
Willow Springs, IL 60480-1666
Phone (708) 467-0657

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210210002316 IA Practitioner - Physical Therapist in Private Practice 2668887399 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070020795ILMDPhysical Therapist
23678MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
On With Life, Inc CurrentSince Feb 1, 2021 Accepting new patients
On With Life, Inc. Physical Therapist CurrentSince Feb 1, 2021 Accepting new patients
On With Life, Inc. Current Accepting new patients
O'Connor Foundation Physical Therapist PastSince Sep 21, 2017 Accepting new patients

Locations

715 SW Ankeny Rd
Ankeny, IA 50023
Phone (515) 289-9600

2854 Coral Ct
Ste 1
Coralville, IA 52241
Phone (319) 259-6224

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1720376627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8434 CORCORAN RD",
            "city": "WILLOW SPRINGS",
            "state": "IL",
            "postal_code": "604801666",
            "telephone_number": "708-467-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2854 CORAL CT STE 1",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412809",
            "telephone_number": "319-259-6224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8434 Corcoran Rd",
            "address_purpose": "LOCATION",
            "city": "Willow Springs",
            "state": "IL",
            "postal_code": "604801666",
            "country_code": "US",
            "telephone_number": "708-467-0657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "JESSICA",
        "middle_name": "LEA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23678",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070020795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.