Active NPI
Cape County Otolaryngology Head & Neck Surgery Inc
- Otolaryngology Physician
- Cape Girardeau, MO
National Provider Identifier
1457538654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- R9980
- Legal business name
- CAPE COUNTY OTOLARYNGOLOGY HEAD & NECK SURGERY INC
- Practice address
- 3203 Blattner Dr
Cape Girardeau, MO 63703-6360 - Phone
- (573) 334-5007
- Fax
- (573) 334-6369
- NPI assigned
- Jan 30, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Walter A Schroeder Jr, DO, MD
- Title
- President
- Phone
- (573) 334-5007
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | R9980 | MO | Primary |
Addresses
Primary practice location
3203 Blattner Dr
Cape Girardeau, MO 63703-6360
Mailing address
3203 Blattner Dr
Cape Girardeau, MO 63703-6360
Phone (573) 334-5007
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26757 | Other | MO | BLUE CROSS BLUE SHIELD |
| 119051 | Other | MO | HEALTH LINK |
| 242087112 | Medicaid | MO |
National Provider Directory
National Provider DirectoryLocations
3203 Blattner Dr
Cpe Girardeau, MO 63703
Phone (314) 334-5007
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201651200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1395187200000",
"number": "1457538654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3203 BLATTNER DR",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637036360",
"telephone_number": "573-334-5007",
"fax_number": "573-334-6369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3203 BLATTNER DR",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "637036360",
"telephone_number": "573-334-5007",
"fax_number": "573-334-6369"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CAPE COUNTY OTOLARYNGOLOGY HEAD & NECK SURGERY INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-30",
"last_updated": "2014-03-19",
"status": "A",
"authorized_official_last_name": "SCHROEDER JR",
"authorized_official_first_name": "WALTER",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "573-334-5007",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DO, MD"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": "MO",
"license": "R9980",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "26757",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH LINK",
"identifier": "119051",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "242087112",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cape Girardeau, MO
- Kuan Cao, DDS
- Capaha Park Inpatient Services, LLC
- Cape Care for Women, LLC
- Cape Chiropractic Clinic LLC
- Cape County Board Fordevelopmental Disabilities
- Cape County Private Ambulance Service, Inc.
- Cape Endodontics, LLC
- Cape Family Care LLC (Cape Family Care)
- Cape Family Medical Clinic, LLC (Cape Family Health)
- Cape Family Medical Clinic, LLC (Cape Family Health)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.