Individual provider Active NPI

Scott T Schroeder, PT

  • Physical Therapist
  • Bloomington, IN
National Provider Identifier
1942715545
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05006789A Issued in IN
Practice address
2605 E Creeks Edge Dr
Bloomington, IN 47401-8368
Phone
(812) 353-3343
Fax
(812) 353-3346
NPI assigned
Dec 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 05006789A IN Primary

Addresses

Primary practice location

2605 E Creeks Edge Dr
Bloomington, IN 47401-8368

Mailing address

2605 E Creeks Edge Dr
Bloomington, IN 47401-8368
Phone (812) 353-3343

Other practice location 1

601 W 2nd St
Bloomington, IN 47403-2317
Phone (812) 353-5252

Other practice location 2

601 W 2nd St
Bloomington, IN 47403-2317
Phone (812) 353-5252

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
05006789AINMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1942715545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 E CREEKS EDGE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018368",
            "telephone_number": "812-353-3343",
            "fax_number": "812-353-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 E CREEKS EDGE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018368",
            "telephone_number": "812-353-3343",
            "fax_number": "812-353-3346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032317",
            "country_code": "US",
            "telephone_number": "812-353-5252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032317",
            "country_code": "US",
            "telephone_number": "812-353-5252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "SCOTT",
        "middle_name": "T",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05006789A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.