NPIMap

Organization Active NPI

Eric O Shreder DO PLLC

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1124232848
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3456 Issued in AZ
Legal business name
ERIC O SHREDER DO PLLC
Practice address
4838 E Baseline Rd
#103
Mesa, AZ 85206-4671
Phone
(480) 926-8000
Fax
(480) 926-3445
NPI assigned
May 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Authorized official

Name
Eric Otto Shreder, DONPI 1982712519
Title
Physician
Phone
(480) 926-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 3456 AZ Primary

Addresses

Primary practice location

4838 E Baseline Rd
#103
Mesa, AZ 85206-4671

Mailing address

4838 E Baseline Rd
#103
Mesa, AZ 85206
Phone (480) 926-8000

National Provider Directory

National Provider Directory

Locations

3651 E Baseline Rd
Ste 104
Gilbert, AZ 85234
Phone (480) 926-8000

4838 E Baseline Rd
Ste 103
Mesa, AZ 85206
Phone (480) 926-8000

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1124232848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4838 E BASELINE RD",
            "address_2": "#103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-926-8000",
            "fax_number": "480-926-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4838 E BASELINE RD",
            "address_2": "#103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064671",
            "telephone_number": "480-926-8000",
            "fax_number": "480-926-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC O SHREDER DO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "SHREDER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "OTTO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "480-926-8000",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.