Active NPI
Frederick C Schubert, M.D.
- Clinical Pathology/Laboratory Medicine Physician
- The Dalles, OR
National Provider Identifier
1477536514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pathology/Laboratory Medicine Physician
- License
- MD14061
- Practice address
- 1700 E 19TH St
The Dalles, OR 97058-3317 - Phone
- (541) 296-7760
- Fax
- (541) 296-7619
- NPI assigned
- Nov 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cytopathology Physician | 207ZC0500X | MD14061 | OR | |
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | MD14061 | OR | Primary |
Addresses
Primary practice location
1700 E 19TH St
The Dalles, OR 97058-3317
Mailing address
1700 E. 19TH St
The Dalles, OR 97058
Phone (541) 296-7760
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8209132 | Medicaid | WA | |
| 050906 | Medicaid | OR |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD14061 | OR | MD | Clinical Pathology/Laboratory Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-Columbia Medical Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Adventist Health Columbia Gorge
- Rural Health Clinic/Center
- The Dalles, OR
- NPI 1154351336
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195430400000",
"number": "1477536514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 E. 19TH ST",
"city": "THE DALLES",
"state": "OR",
"postal_code": "97058",
"telephone_number": "541-296-7760",
"fax_number": "541-296-7619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 E 19TH ST",
"city": "THE DALLES",
"state": "OR",
"postal_code": "970583317",
"telephone_number": "541-296-7760",
"fax_number": "541-296-7619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHUBERT",
"first_name": "FREDERICK",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-22",
"last_updated": "2007-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "OR",
"license": "MD14061",
"primary": false
},
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "OR",
"license": "MD14061",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8209132",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "050906",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in The Dalles, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.