Active NPI
Shaun Schroeder
- Mental Health Counselor
- Martelle, IA
National Provider Identifier
1073125944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 101114
- Practice address
- 112 Mechanic St
Martelle, IA 52305-7716 - Phone
- (319) 480-6753
- NPI assigned
- Aug 20, 2020
- Last updated
- Aug 20, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 101114 | IA | Primary |
Addresses
Primary practice location
112 Mechanic St
Martelle, IA 52305-7716
Mailing address
112 Mechanic St
Martelle, IA 52305-7716
Phone (319) 480-7321
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://lifeconnections.kasa-solutions.com/index.php | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101114 | IA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597881600000",
"number": "1073125944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 MECHANIC ST",
"city": "MARTELLE",
"state": "IA",
"postal_code": "523057716",
"telephone_number": "319-480-7321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 MECHANIC ST",
"city": "MARTELLE",
"state": "IA",
"postal_code": "523057716",
"telephone_number": "319-480-6753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROEDER",
"first_name": "SHAUN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-20",
"last_updated": "2020-08-20",
"certification_date": "2020-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "101114",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://lifeconnections.kasa-solutions.com/index.php",
"affiliation": "N",
"endpointDescription": "EHR system-Kasa Practice Solutions",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "215 4th Ave SE",
"city": "Cedar Rapids",
"state": "IA",
"country_code": "US",
"postal_code": "524011844",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.