Provider Demographics
NPI:1356315097
Name:SCHMIDT, EMILIE (DPT, SCS, ATC, CSCS)
Entity Type:Individual
Prefix:DR
First Name:EMILIE
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:DPT, SCS, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-3203
Mailing Address - Country:US
Mailing Address - Phone:910-381-5375
Mailing Address - Fax:
Practice Address - Street 1:133 MAGNOLIA AVE SE
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32548-7266
Practice Address - Country:US
Practice Address - Phone:850-499-0776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171000000X, 2251S0007X
NC86592251X0800X
MEAT8102255A2300X
MEPT57242251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No171000000XOther Service ProvidersMilitary Health Care Provider
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC078K5OtherBCBS
NC7211423Medicaid
Q49681AMedicare UPIN