NPIMap

Individual provider Active NPI

Teresa L Schroder, AUD., CCC-A

  • Audiologist
  • Montgomery, TX
National Provider Identifier
1285788653
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
80734 Issued in TX
Practice address
18059 Highway 105 W Ste 115
Montgomery, TX 77356-5001
Phone
(936) 582-7000
Fax
(936) 582-7001
NPI assigned
Jan 23, 2007
Last updated
Jul 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 00005 KS
Audiologist 231H00000X 80734 TX Primary

Addresses

Primary practice location

18059 Highway 105 W Ste 115
Montgomery, TX 77356-5001

Mailing address

18059 Highway 105 W Ste 115
Montgomery, TX 77356-5001
Phone (936) 582-7000

Other identifiers 1

IdentifierTypeStateIssuer
40137017OtherKSBCBS

Other names 1

  • Mrs. Teresa L Kennalley Former name

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

State licenses

LicenseStateTypeSpecialty
00005KSMDAudiologist
80734TXMDAudiologist
5KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ku Health Partners, Inc Audiologist Past Accepting new patients
Spine and Extremity Rehabilitation Center of Raytown Inc Past Accepting new patients
Mid America Balance Institute of Cass County Missouri Past Accepting new patients
Mid America Balance Institute of Clay Platte County Missouri Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1285788653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18059 HIGHWAY 105 W STE 115",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773565001",
            "telephone_number": "936-582-7000",
            "fax_number": "936-582-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18059 HIGHWAY 105 W STE 115",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773565001",
            "telephone_number": "936-582-7000",
            "fax_number": "936-582-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRODER",
        "first_name": "TERESA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "AUD., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KS",
            "license": "00005",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "80734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "40137017",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "KENNALLEY",
            "middle_name": "L",
            "prefix": "MRS.",
            "credential": "AUD.,CCC-A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montgomery, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.