Mark Richard Schroder, PSY. D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4776 Issued in OH

Practice address

2810 Mack Road
Fairfield, OH 45014-5130

Phone

(513) 874-4530

Fax

(513) 346-3811

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• C Crystal Psych

  • Psychologist
  • Fairfield, OH
  • NPI 1750818225
  NPD (past)
• Rachel M Sparn LLC

  • Adult Mental Health Clinic/Center
  • Fairfield, OH
  • NPI 1558805713
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1154489417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 MACK ROAD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145130",
            "telephone_number": "513-874-4530",
            "fax_number": "513-346-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 MACK ROAD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145130",
            "telephone_number": "513-874-4530",
            "fax_number": "513-346-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRODER",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000020680",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PCN",
            "identifier": "07 239 039",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cindy Collett Schneider, OTR
• Shelly Schofstoll
• Peggy Crema Schomaker, D.D.S.
• Katherine Schreiner
• Ruth C Schrider, LISW-S
• Meredith Schroeder
• Michael Schroeder, RN
• Jeff Schuka
• Allison Bailey Schuler, PT
• Patricia R Schumm, MS/LPCC

• Clinical Psychologist in Fairfield, OH
• Providers in Fairfield, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.