Individual provider Active NPI

Karen Elizabeth Shrader, MD

  • Family Medicine Physician
  • Gun Barrel City, TX
National Provider Identifier
1467556100
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G3787 Issued in TX
Practice address
429 N Gun Barrel Lane
Suite 111
Gun Barrel City, TX 75156
Phone
(903) 887-2704
Fax
(903) 887-4910
NPI assigned
Sep 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G3787 TX Primary

Addresses

Primary practice location

429 N Gun Barrel Lane
Suite 111
Gun Barrel City, TX 75156

Mailing address

429 N Gun Barrel Lane
Suite 111
Gun Barrel City, TX 75156
Phone (903) 887-2704

Other identifiers 2

IdentifierTypeStateIssuer
8B2550OtherBCBS
4335905OtherAETNA

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
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1467556100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 N GUN BARREL LANE",
            "address_2": "SUITE 111",
            "city": "GUN BARREL CITY",
            "state": "TX",
            "postal_code": "75156",
            "telephone_number": "903-887-2704",
            "fax_number": "903-887-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 N GUN BARREL LANE",
            "address_2": "SUITE 111",
            "city": "GUN BARREL CITY",
            "state": "TX",
            "postal_code": "75156",
            "telephone_number": "903-887-2704",
            "fax_number": "903-887-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRADER",
        "first_name": "KAREN",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G3787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8B2550",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4335905",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gun Barrel City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; 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.