Active NPI
Thomas Schroeder, MD
- Family Medicine Physician
- Cedar Rapids, IA
National Provider Identifier
1114995230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20385
- Practice address
- 3933 Mount Vernon Rd SE
Cedar Rapids, IA 52403-3869 - Phone
- (319) 363-8149
- Fax
- (319) 363-9118
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20385 | IA | Primary |
Addresses
Primary practice location
3933 Mount Vernon Rd SE
Cedar Rapids, IA 52403-3869
Mailing address
PO Box 1824
Cedar Rapids, IA 52406-1824
Phone (319) 369-4505
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3152173 | Medicaid | IA |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20385 | IA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193270400000",
"number": "1114995230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1824",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524061824",
"telephone_number": "319-369-4505",
"fax_number": "319-369-4677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3933 MOUNT VERNON RD SE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524033869",
"telephone_number": "319-363-8149",
"fax_number": "319-363-9118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROEDER",
"first_name": "THOMAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2007-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "20385",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3152173",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.