Individual provider Active NPI

Victoria Schmelzer

  • Nurse Practitioner
  • Manchester, IA
National Provider Identifier
1417312893
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
D165533 Issued in IA
Practice address
709 W Main St
Manchester, IA 52057-1526
Phone
(904) 303-2400
NPI assigned
Dec 29, 2015
Last updated
Jul 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X D165533 IA Primary

Addresses

Primary practice location

709 W Main St
Manchester, IA 52057-1526

Mailing address

88515 Weiss Estates Rd Apt Suite
Bandon, OR 97411-6320
Phone (904) 303-2400

Other practice location 1

900 11th St SE Apt Suite
Bandon, OR 97411-9114
Phone (541) 396-4578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WV, IN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20160201003082 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688568702 Reassigns benefits to 2 organizations
I20160719002556 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688568702
I20190214001239 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4688568702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Mayo Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Coos Health DistrictGroup PAC ID 1951219310, 25 clinicians

Practice addresses (Care Compare)

900 11TH St SE
Bandon, OR 97411-9114
Phone (541) 347-2426

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
D165533IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Coos Health District CurrentSince Apr 19, 2019 Accepting new patients
Southern Coos Health District CurrentSince Apr 19, 2019 Accepting new patients

Locations

900 11th St SE
Bandon, OR 97411
Phone (541) 237-2426

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1417312893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88515 WEISS ESTATES RD APT SUITE",
            "city": "BANDON",
            "state": "OR",
            "postal_code": "974116320",
            "telephone_number": "904-303-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 W MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571526",
            "telephone_number": "904-303-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 11th St SE Apt Suite",
            "address_purpose": "LOCATION",
            "city": "Bandon",
            "state": "OR",
            "postal_code": "974119114",
            "country_code": "US",
            "telephone_number": "541-396-4578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHMELZER",
        "first_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-29",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "D165533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.