NPIMap

Individual provider Active NPI

Kelly A Schroeder, MD

  • Internal Medicine Physician
  • Lima, OH
National Provider Identifier
1194861682
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
80801 Issued in OH
Practice address
750 W High St
Suite # 250
Lima, OH 45801-2969
Phone
(419) 227-7399
Fax
(419) 229-0123
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 80801 OH Primary

Addresses

Primary practice location

750 W High St
Suite # 250
Lima, OH 45801-2969

Mailing address

PO Box 636930
Cincinnati, OH 45263-0001
Phone (513) 981-5015

Other identifiers 1

IdentifierTypeStateIssuer
2317157MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050105000975 OH Practitioner - Internal Medicine 6507814639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Cincinnati College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Lima, LLCGroup PAC ID 3375607351, 54 clinicians

Practice addresses (Care Compare)

750 W High St
Suite 250
Lima, OH 45801-3959
Phone (419) 227-7399

Hospital & facility affiliations

  • Mercy Health-Home Health, Lima Home health agency, Lima, OH, CCN 367417
  • Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066
  • Lima Memorial Health System Hospital, Lima, OH, CCN 360009
  • Mercer County Joint Township Community Hospital Hospital, Coldwater, OH, CCN 360058
  • Grand Lake Health System Hospital, Saint Marys, OH, CCN 360032
  • Institute for Orthopaedic Surgery Hospital, Lima, OH, CCN 360263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
80801OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC Internal Medicine CurrentSince Jan 1, 2007 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
General Medical Consultants, Inc Internal Medicine Past Accepting new patients

Locations

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

3200 Burnet Ave
Cincinnati, OH 45229
Phone (513) 558-7700

Interoperability endpoints

  • Direct secure messaging: kschroeder39564@direct.bsmhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1194861682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636930",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001",
            "telephone_number": "513-981-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 W HIGH ST",
            "address_2": "SUITE # 250",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458012969",
            "telephone_number": "419-227-7399",
            "fax_number": "419-229-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "80801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2317157",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.