Individual provider Active NPI

Debra Damico Schmitz, OT

  • Occupational Therapist
  • Milwaukee, WI
National Provider Identifier
1831230358
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056006553 Issued in IL
Practice address
2555 N Gordon PL
Milwaukee, WI 53212
Phone
(414) 378-5303
Fax
(414) 376-5552
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 6197-26 WI
Occupational Therapist 225X00000X 056006553 IL Primary

Addresses

Primary practice location

2555 N Gordon PL
Milwaukee, WI 53212

Mailing address

2555 N Gordon PL
Milwaukee, WI 53212-3018
Phone (414) 378-5303

Other practice location 1

258 Marseilles St
Vernon Hills, IL 60061-4147
Phone (847) 702-1542

Other identifiers 2

IdentifierTypeStateIssuer
710957905OtherILFEIN
04932271OtherILBLUE SHIELD

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
056006553ILMDOccupational Therapist
6197-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids in Balance PastSince Dec 9, 2019 Accepting new patients
Carrie Cicciu-Singer, PT Inc. Past Accepting new patients
The Therapy Tree D.B.a. Birth to Three & Beyond Pediatric Therapies Specialist Past Accepting new patients
Carrie Cicciu-Singer, PT Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1831230358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 N GORDON PL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123018",
            "telephone_number": "414-378-5303",
            "fax_number": "414-376-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 N GORDON PL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53212",
            "telephone_number": "414-378-5303",
            "fax_number": "414-376-5552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "258 Marseilles St",
            "address_purpose": "LOCATION",
            "city": "Vernon Hills",
            "state": "IL",
            "postal_code": "600614147",
            "country_code": "US",
            "telephone_number": "847-702-1542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHMITZ",
        "first_name": "DEBRA",
        "middle_name": "DAMICO",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6197-26",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056006553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEIN",
            "identifier": "710957905",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "04932271",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.