Healthcare Provider Details

I. General information

NPI: 1659771954
Provider Name (Legal Business Name): TREVOR SCHMIDT DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2014
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4623 ENTERPRISE WAY
CALDWELL ID
83605-6764
US

IV. Provider business mailing address

1714 CANTERBURY RD
RALEIGH NC
27608-1110
US

V. Phone/Fax

Practice location:
  • Phone: 919-213-0504
  • Fax: 919-981-9213
Mailing address:
  • Phone: 919-213-0504
  • Fax: 919-981-9213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-5324
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number62383
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: