Shannon Schroeder, DPT

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

15775-24 Issued in WI

Practice address

210 Wisconsin American Dr
Fond Du Lac, WI 54937-2999

Phone

(920) 907-7270

NPI assigned

Aug 29, 2022

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": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1831819242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 VALLEY ST.",
            "city": "HORICON",
            "state": "WI",
            "postal_code": "53032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WISCONSIN AMERICAN DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549372999",
            "telephone_number": "920-907-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "SHANNON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2024-08-06",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "WI",
            "license": "15775-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly M School, PTA
• Gracie Louise Schraa, COTA/L
• Amy L Schraufnagel, MOTS/OT
• Taylor B Schregardus, DC
• Laurie Schroeder
• Sandra M Schug, MS, LPC-IT, CSAC
• Laura Schultz, RN
• Mary M Schultz, MD
• Sarah Schultz, MS, LAT
• James E Schuster, MD

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.