Individual provider Active NPI

Kerri Schackmann

  • Hearing Instrument Specialist
  • Effingham, IL
National Provider Identifier
1083028559
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
3011 Issued in IL
Practice address
212 E Jefferson Ave Ste 2
Effingham, IL 62401-3458
Phone
(217) 342-0304
NPI assigned
Jun 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 3011 IL Primary

Addresses

Primary practice location

212 E Jefferson Ave Ste 2
Effingham, IL 62401-3458

Mailing address

212 E Jefferson Ave Ste 2
Effingham, IL 62401-3458
Phone (217) 342-0304

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

LicenseStateTypeSpecialty
3011ILMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Schackmann Hearing Group LLC Hearing Instrument Specialist CurrentSince Dec 21, 2021 Accepting new patients

Locations

212 E Jefferson Ave
Ste 2
Effingham, IL 62401
Phone (217) 342-0304

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1083028559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 E JEFFERSON AVE STE 2",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624013458",
            "telephone_number": "217-342-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E JEFFERSON AVE STE 2",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624013458",
            "telephone_number": "217-342-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHACKMANN",
        "first_name": "KERRI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2021-12-16",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "IL",
            "license": "3011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Effingham, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.