Individual provider Active NPI

Leora Josepha Gardner-Schauder, PHD

  • Clinical Psychologist
  • Boca Raton, FL
National Provider Identifier
1144338120
Registry record updated Sep 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY5116 Issued in FL
Practice address
1499 W Palmetto Park Rd
Ste 172
Boca Raton, FL 33486-3328
Phone
(561) 414-1650
Fax
(561) 423-7961
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY5116 FL Primary

Addresses

Primary practice location

1499 W Palmetto Park Rd
Ste 172
Boca Raton, FL 33486-3328

Mailing address

222 Yamato Rd
Ste 106-333
Boca Raton, FL 33431-4704
Phone (561) 414-1650

Other identifiers 1

IdentifierTypeStateIssuer
002347800MedicaidFL

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 Philosophy

State licenses

LicenseStateTypeSpecialty
PY5116FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gardner Solar Psychology Center Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441411200000",
    "number": "1144338120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 YAMATO RD",
            "address_2": "STE 106-333",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314704",
            "telephone_number": "561-414-1650",
            "fax_number": "561-423-7961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 W PALMETTO PARK RD",
            "address_2": "STE 172",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334863328",
            "telephone_number": "561-414-1650",
            "fax_number": "561-423-7961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER-SCHAUDER",
        "first_name": "LEORA",
        "middle_name": "JOSEPHA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2015-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY5116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002347800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2015; 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.