Individual provider Active NPI

Amber S Schroeder, PTA

  • Physical Therapy Assistant
  • Appleton, WI
National Provider Identifier
1881852275
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1407019 Issued in WI
Practice address
601 N Briarcliff Dr
Appleton, WI 54915-2959
Phone
(920) 739-4466
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1407019 WI Primary

Addresses

Primary practice location

601 N Briarcliff Dr
Appleton, WI 54915-2959

Mailing address

601 Briarcliff Dr
Appleton, WI 54915
Phone (920) 739-4466

Other identifiers 1

IdentifierTypeStateIssuer
361633000MedicaidWI

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
1407019WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1881852275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 BRIARCLIFF DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54915",
            "telephone_number": "920-739-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N BRIARCLIFF DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549152959",
            "telephone_number": "920-739-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "AMBER",
        "middle_name": "S",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1407019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "361633000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.