Individual provider Active NPI

Elisha F Schnieders, CPNP

  • Pediatric Nurse Practitioner
  • Waterloo, IL
National Provider Identifier
1093978678
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
041416808 Issued in IL
Practice address
509 Hamacher St
Suite 103
Waterloo, IL 62298-1592
Phone
(618) 939-2273
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 2003017875 MO
Pediatric Nurse Practitioner 363LP0200X 2003017875 MO
Pediatric Nurse Practitioner 363LP0200X 041416808 IL Primary

Addresses

Primary practice location

509 Hamacher St
Suite 103
Waterloo, IL 62298-1592

Mailing address

6804 Lindenwood PL
Saint Louis, MO 63109-1248
Phone (618) 806-2966

Other names 1

  • Elisha F Schnieders Other name

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)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041416808ILMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: eschnieders768363@directc.mercy.net

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1093978678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6804 LINDENWOOD PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631091248",
            "telephone_number": "618-806-2966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 HAMACHER ST",
            "address_2": "SUITE 103",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981592",
            "telephone_number": "618-939-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNIEDERS",
        "first_name": "ELISHA",
        "middle_name": "F",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MO",
            "license": "2003017875",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2003017875",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "041416808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISHA",
            "last_name": "SCHNIEDERS",
            "middle_name": "F",
            "credential": "CPNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waterloo, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.