Stanton G Schultz, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

1027161 Issued in IN

Practice address

416 North 12TH Street
Southern Illinois Consultants for Kidney Disease, S.C.
Mt. Vernon, IL 62864-4314

Phone

(618) 244-4850

Fax

(618) 244-7985

NPI assigned

Jul 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Southern Illinois Consultants for Kidney Disease, S.C.

  • Specialist
  • Mount Vernon, IL
  • NPI 1144283300
  NPD (past)
• Renal Life Link Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • New Hope, MN
  • NPI 1477875243
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1073513313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1704",
            "address_2": "416 NORTH 12TH STREET",
            "city": "MT. VERNON",
            "state": "IL",
            "postal_code": "628640034",
            "telephone_number": "618-244-4850",
            "fax_number": "618-244-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 NORTH 12TH STREET",
            "address_2": "SOUTHERN ILLINOIS CONSULTANTS FOR KIDNEY DISEASE, S.C.",
            "city": "MT. VERNON",
            "state": "IL",
            "postal_code": "628644314",
            "telephone_number": "618-244-4850",
            "fax_number": "618-244-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "STANTON",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IN",
            "license": "1027161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100246480",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390004295",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anton Schittek, M.D.
• Lorianne Catherine Schmider, PHD, LCPC, NCC
• Jaime Schneider, PHARMD
• Katie Marie Schrementi, M.S CCC-SLP
• Sally Joan Schroeter, PTA
• Esther Schulz, DO
• Vanessa Lea Schumm, PHARMD
• Amber Phelps Schweda, LCPC
• Raistlyn Scott
• Richard Lawrence Scott III, CRNA

• Nephrology Physician in Mt. Vernon, IL
• Providers in Mt. Vernon, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.