Active NPI
Jeanne M Schaefer, MD
- Pediatrics Physician
- Edmond, OK
National Provider Identifier
1114992740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 18963
- Practice address
- 523 S Santa Fe Ave Ste B
Edmond, OK 73003-6291 - Phone
- (405) 509-6777
- Fax
- (405) 509-6778
- NPI assigned
- Feb 17, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 18963 | OK | Primary |
Addresses
Primary practice location
523 S Santa Fe Ave Ste B
Edmond, OK 73003-6291
Mailing address
PO Box 270
Edmond, OK 73083-0270
Phone (405) 509-6777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100205560B | Medicaid | OK |
Other names 1
- Jeanne M Schaefer-Sims
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18963 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeanne M Schaefer MD PLLC | Pediatrics | Current | Accepting new patients |
| Summit Medical Center | Past | Accepting new patients | |
| Aky MD, LLC | Pediatrics | Past | Accepting new patients |
Locations
1700 Renaissance Blvd
Edmond, OK 73013
Phone (405) 844-3800
523 S Santa Fe Ave
Ste B
Edmond, OK 73003
Phone (405) 285-0660
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.973232
Organizations & group practices 3
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.
-
- Pediatrics Physician
- Edmond, OK
- NPI 1366614356
-
- Pediatrics Physician
- Moore, OK
- NPI 1063846699
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594944000000",
"number": "1114992740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 270",
"city": "EDMOND",
"state": "OK",
"postal_code": "730830270",
"telephone_number": "405-509-6777",
"fax_number": "405-509-6778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "523 S SANTA FE AVE STE B",
"city": "EDMOND",
"state": "OK",
"postal_code": "730036291",
"telephone_number": "405-509-6777",
"fax_number": "405-509-6778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHAEFER",
"first_name": "JEANNE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-17",
"last_updated": "2020-07-17",
"certification_date": "2020-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OK",
"license": "18963",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100205560B",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JEANNE",
"last_name": "SCHAEFER-SIMS",
"middle_name": "M",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.