Individual provider Active NPI

Cory J Schneider VIII, PT

  • Physical Therapist
  • Nashotah, WI
National Provider Identifier
1922187665
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6209 Issued in WI
Practice address
W331N3365 Chestnut CT
Nashotah, WI 53058
Phone
(262) 646-5057
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6209 WI Primary

Addresses

Primary practice location

W331N3365 Chestnut CT
Nashotah, WI 53058

Mailing address

W331N3365 Chestnut CT
Nashotah, WI 53058
Phone (262) 646-5057

Other identifiers 1

IdentifierTypeStateIssuer
40330600MedicaidWI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6209WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evolution Exercise and Spine Center of Madison LLC Physical Therapist PastSince Jan 1, 2004 Accepting new patients
Apps Chiropractic and Wellness Center Inc PastSince Jul 24, 2022 Accepting new patients
Lakeshore Medical Clinic, LLC Physical Therapist Past Accepting new patients
Evolution Exercise & Spine Center Physical Therapist PastSince Nov 1, 2011 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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922187665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W331N3365 CHESTNUT CT",
            "city": "NASHOTAH",
            "state": "WI",
            "postal_code": "53058",
            "telephone_number": "262-646-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W331N3365 CHESTNUT CT",
            "city": "NASHOTAH",
            "state": "WI",
            "postal_code": "53058",
            "telephone_number": "262-646-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "CORY",
        "middle_name": "J",
        "name_suffix": "VIII",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "6209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40330600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashotah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.