NPIMap

Individual provider Active NPI

Louise Schroder

  • Gerontology Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1417579160
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
29231 Issued in TN
Practice address
701 N State of Franklin Rd Ste 2
Johnson City, TN 37604-3645
Phone
(423) 926-4468
Fax
(423) 928-4838
NPI assigned
May 15, 2020
Last updated
Dec 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 29231 TN Primary

Addresses

Primary practice location

701 N State of Franklin Rd Ste 2
Johnson City, TN 37604-3645

Mailing address

701 N State of Franklin Rd Ste 2
Johnson City, TN 37604-3645
Phone (423) 926-4468

Other names 1

  • Louise Crisp Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20210716000223 TN Practitioner - Nurse Practitioner 1052713856 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Practice addresses (Care Compare)

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC CurrentSince Jan 1, 2023 Accepting new patients
Ipc Pac Healthcare Services of Tennessee PC CurrentSince Apr 21, 2025 Accepting new patients
CS Pacs 3 Southeast, LLC CurrentSince Apr 21, 2025 Accepting new patients
NV Pacs 2 LLC CurrentSince Apr 21, 2025 Accepting new patients
Karing Hearts Cardiology PC CurrentSince Jul 1, 2021 Accepting new patients
Karing Hearts Cardiology, PLLC Past Accepting new patients

Locations

627 N Main Ave
Erwin, TN 37650
Phone (423) 341-0629

880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

701 N State of Franklin Rd
Ste 2
Johnson City, TN 37604
Phone (423) 477-0600

701 N State of Franklin Rd
Ste 9
Johnson City, TN 37604
Phone (423) 850-0776

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Organizations & group practices 6

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 8

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": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1417579160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N STATE OF FRANKLIN RD STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043645",
            "telephone_number": "423-926-4468",
            "fax_number": "423-928-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N STATE OF FRANKLIN RD STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043645",
            "telephone_number": "423-926-4468",
            "fax_number": "423-928-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRODER",
        "first_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "29231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOUISE",
            "last_name": "CRISP",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.