Individual provider Active NPI

Matthew Carl Schrader, D.C.

  • Chiropractor
  • Lorain, OH
National Provider Identifier
1043612500
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4452 Issued in OH
Practice address
1680 Cooper Foster Park Rd W
Lorain, OH 44053-3657
Phone
(616) 510-9128
Fax
(440) 282-1925
NPI assigned
Sep 16, 2014
Last updated
Feb 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4452 OH Primary

Addresses

Primary practice location

1680 Cooper Foster Park Rd W
Lorain, OH 44053-3657

Mailing address

1680 Cooper Foster Park Rd W
Lorain, OH 44053-3657
Phone (616) 510-9128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211004518 MI Practitioner - Chiropractic 8921534041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eric R Hartman, DC, PLLCGroup PAC ID 2062554124, 2 clinicians

Practice addresses (Care Compare)

302 Baldwin St
Jenison, MI 49428-7909
Phone (616) 457-1168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4452OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Eric R Hartman, DC, PLLC Chiropractor CurrentSince Dec 2, 2024 Accepting new patients

Locations

302 Baldwin St
Jenison, MI 49428
Phone (616) 457-1168

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1043612500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 COOPER FOSTER PARK RD W",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533657",
            "telephone_number": "616-510-9128",
            "fax_number": "440-282-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 COOPER FOSTER PARK RD W",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533657",
            "telephone_number": "616-510-9128",
            "fax_number": "440-282-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRADER",
        "first_name": "MATTHEW",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-16",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.