Active NPI
Sandra Lee Schoonover, PH.D.
- Clinical Psychologist
- Matthews, NC
National Provider Identifier
1114070133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3342
- Practice address
- 3320 Siskey Pkwy Ste 101
Matthews, NC 28105-3224 - Phone
- (704) 996-2654
- Fax
- (704) 996-2654
- NPI assigned
- Jan 21, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3342 | NC | Primary |
Addresses
Primary practice location
3320 Siskey Pkwy Ste 101
Matthews, NC 28105-3224
Mailing address
9010 Ladys Secret Dr
Indian Trail, NC 28079-5712
Phone (704) 996-2654
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170717000360 | NC | Practitioner - Psychologist Billing Independently | 5890065387 | Practice locations: Matthews, NC |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2536 Platation Ctr Dr
Suite B
Matthews, NC 28105
Phone (704) 996-2654
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3342 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1114070133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9010 LADYS SECRET DR",
"city": "INDIAN TRAIL",
"state": "NC",
"postal_code": "280795712",
"telephone_number": "704-996-2654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3320 SISKEY PKWY STE 101",
"city": "MATTHEWS",
"state": "NC",
"postal_code": "281053224",
"telephone_number": "704-996-2654",
"fax_number": "704-996-2654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHOONOVER",
"first_name": "SANDRA",
"middle_name": "LEE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-21",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "3342",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Matthews, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.