Justine Schrader

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

4704278975 Issued in MI

Practice address

1979 Holland Ave
Port Huron, MI 48060-8639

Phone

(810) 982-1200

NPI assigned

Sep 23, 2015

Reactivated

Feb 23, 2018

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GFAFCD/Endpoint/GFAFCD

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1003285859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7244 2ND ST",
            "city": "LAKEPORT",
            "state": "MI",
            "postal_code": "480591903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1979 HOLLAND AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480608639",
            "telephone_number": "810-982-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5500 Armstrong Rd",
            "address_purpose": "LOCATION",
            "city": "Battle Creek",
            "state": "MI",
            "postal_code": "490377314",
            "country_code": "US",
            "telephone_number": "269-966-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHRADER",
        "first_name": "JUSTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2018-03-17",
        "deactivation_date": "2018-02-06",
        "reactivation_date": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704278975",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "MI",
            "license": "4704278975",
            "primary": false
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "MI",
            "license": "4704278975",
            "primary": false
        },
        {
            "code": "364SP2800X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Perioperative",
            "state": "MI",
            "license": "4704278975",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704278975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Eileen Margaret Schoenberg, LPC
• Heather Lynn Scholfield, M.A., L.L.P.
• Michelle Renee Schonschack
• Carla Schott
• Nicole Schott, MSOT, OTRL
• Jessica Schroeder, LMSW
• Paul Michael Schroll
• David H Schulman, DO
• Ann Marie Schultz, CPT, JD
• Mallory Nicole Schultz, AGACNP-BC

• Primary Care Nurse Practitioner in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Primary Care Nurse Practitioner in Michigan

• 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.