Schryver Medical Sales and Marketing, LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

License

C 179257 Issued in ID

Legal business name

SCHRYVER MEDICAL SALES AND MARKETING, LLC

Doing business as

Schryver Medical

Practice address

2399 S Orchard St
105
Boise, ID 83705-3793

Phone

(303) 371-0073

Fax

(303) 785-9283

NPI assigned

Jul 29, 2008

Last updated

Oct 2, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Doug R Goetz

Title

Ceo

Phone

(303) 371-0073

Specialties & licenses 1

Addresses

Other names 1

• Schryver Medical Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104082221. Details of each certification follow.

• CCN 13X0009803 Portable X-ray supplier · Active · Name & address match · Details

Portable X-ray supplier certification: CCN 13X0009803

Legal name

SCHRYVER MEDICAL SALES AND MARKETING, INC

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Feb 21, 2007

Last certification

Feb 21, 2007

Ownership / control type

OTHER THAN PRIVATE

Facility address

2399 South Orchard #105
Boise, ID 83705

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1104082221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12075 E 45TH AVE",
            "address_2": "SUITE 600",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802393136",
            "telephone_number": "303-371-0073",
            "fax_number": "303-785-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2399 S ORCHARD ST",
            "address_2": "105",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837053793",
            "telephone_number": "303-371-0073",
            "fax_number": "303-785-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHRYVER MEDICAL SALES AND MARKETING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-29",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "GOETZ",
        "authorized_official_first_name": "DOUG",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "303-371-0073"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "ID",
            "license": "C 179257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Schryver Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joan Kathleen Schramm, LCP
• Amanda Lauren Schroeder, MS, LPC
• Connie Koepke Schroeder, OTR
• Kalie Ann Schroeder
• Seth Thomas Schroeder
• Schryver Medical Sales and Marketing, LLC
• Matthew Schubert, LPC
• Lowell A Schuknecht Jr., M.D.
• Michaela Schulte, MD
• Alexandria Marie Schultz

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Boise, ID
• Providers in Boise, ID by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.