Active NPI
Keith Lamar Stroder, CNP
- Family Nurse Practitioner
- Holland, OH
National Provider Identifier
1487183067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 020866
- Practice address
- 6855 Spring Valley Dr Ste 150
Holland, OH 43528-7012 - Phone
- (419) 724-0004
- Fax
- (888) 677-1987
- NPI assigned
- Jun 7, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 020866 | OH | Primary |
Addresses
Primary practice location
6855 Spring Valley Dr Ste 150
Holland, OH 43528-7012
Mailing address
4423 Copper Creek LN
Toledo, OH 43615-7024
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kstoder130128@epicdirect.promedica.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020866 | OH | MD | Family Nurse Practitioner |
Interoperability endpoints
- kstroder130128@direct.promedica.org
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1487183067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4423 COPPER CREEK LN",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436157024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6855 SPRING VALLEY DR STE 150",
"city": "HOLLAND",
"state": "OH",
"postal_code": "435287012",
"telephone_number": "419-724-0004",
"fax_number": "888-677-1987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRODER",
"first_name": "KEITH",
"middle_name": "LAMAR",
"credential": "CNP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-07",
"last_updated": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "020866",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kstoder130128@epicdirect.promedica.org",
"affiliation": "N",
"address_1": "100 Madison Ave",
"city": "Toledo",
"state": "OH",
"country_code": "US",
"postal_code": "436041516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Holland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.