Individual provider Active NPI

Timothy Kaiser Schoenfelder, MD

  • Anesthesiology Physician
  • La Grande, OR
National Provider Identifier
1174569321
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD15398 Issued in OR
Practice address
900 Sunset Dr
La Grande, OR 97850-1362
Phone
(541) 963-8421
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD15398 OR Primary

Addresses

Primary practice location

900 Sunset Dr
La Grande, OR 97850-1362

Mailing address

PO Box 4008
Portland, OR 97208-4008
Phone (503) 372-2740

Other identifiers 1

IdentifierTypeStateIssuer
165027MedicaidOR

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

LicenseStateTypeSpecialty
MD15398ORMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1174569321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4008",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084008",
            "telephone_number": "503-372-2740",
            "fax_number": "503-372-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SUNSET DR",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501362",
            "telephone_number": "541-963-8421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOENFELDER",
        "first_name": "TIMOTHY",
        "middle_name": "KAISER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD15398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165027",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.