Sandra Marie Schultz

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

6296 Bridgeport Village Square Dr Ste 2
Bridgeport, MI 48722-9655

Phone

(989) 401-1239

NPI assigned

Aug 16, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Autism Systems LLC

  • Behavior Analyst
  • Fort Gratiot, MI
  • NPI 1972030724
  NPD

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1952827552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5039 VILLA LINDE PKWY STE 30",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323450",
            "telephone_number": "989-401-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6296 BRIDGEPORT VILLAGE SQUARE DR STE 2",
            "city": "BRIDGEPORT",
            "state": "MI",
            "postal_code": "487229655",
            "telephone_number": "989-401-1239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41521 W 11 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483751803",
            "country_code": "US",
            "telephone_number": "248-299-0030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "SANDRA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Schaack
• Sophia Louise Schmidt
• Samantha Rae Schroeder
• Breanna Lee Schultz
• Megan Schultz
• Morgan Schwanbeck
• Lakeshia J Scott, BA
• Raeaunna Scott
• Stacia Scott
• Serenity Hospice of Michigan

• All providers in Bridgeport, MI
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.