Kerri Stephanie Schroder, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301007993 Issued in MI

Practice address

2226 S Airport Rd W
Suite a
Traverse City, MI 49684-4706

Phone

(231) 947-2442

Fax

(231) 947-2446

NPI assigned

Feb 13, 2007

Last updated

Jun 13, 2008By the provider in NPPES

Sex

Female

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 3

Medicare fee-for-service enrollment

Enrolled in MI, NC, TX3 enrollments

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 3

Specialty

Clinical Psychologist

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psy-Med, Inc.Group PAC ID 5092863662, 12 clinicians

Chrysalis Center for Counseling and Eating Disorder Treatment PLLCGroup PAC ID 4183765068, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chrysalis Center for Counseling and Eating Disorder Treatment PLLC

  • Psychologist
  • Wilmington, NC
  • NPI 1891865218
  Medicare reassignment Care Compare group NPD
• Psy-Med, Inc.

  • Health Psychologist
  • Dallas, TX
  • NPI 1881842102

  MI

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1205978681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2226 S AIRPORT RD W",
            "address_2": "SUITE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844706",
            "telephone_number": "231-947-2442",
            "fax_number": "231-947-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 S AIRPORT RD W",
            "address_2": "SUITE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844706",
            "telephone_number": "231-947-2442",
            "fax_number": "231-947-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRODER",
        "first_name": "KERRI",
        "middle_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301007993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUOPTIONS",
            "identifier": "037258",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH VENDOR #",
            "identifier": "900002404",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0B81206",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald Jay Scholten II, MD PHD
• Kristen Duman Scholten, M.D.
• Stevie Marie Scholten, BAS
• Trevor R Schook, CRNA
• Jason Skylar Schreiber, DO
• Angela Schroeder
• Gregory Schroeder, LMSW
• Nicole Schroeder
• Curt Jeffrey Schubert, M.D.
• Matthew David Schuch

• Clinical Psychologist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.