Active NPI
Robert C Schnackenberg, MD
- Psychiatry Physician
- Columbia, SC
National Provider Identifier
1548240484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 5816
- Practice address
- 1415 Blanding St
Suite 4
Columbia, SC 29201-2922 - Phone
- (803) 779-7500
- Fax
- (803) 779-7522
- NPI assigned
- Jan 18, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 5816 | SC | |
| Psychiatry Physician | 2084P0800X | 5816 | SC | Primary |
Addresses
Primary practice location
1415 Blanding St
Suite 4
Columbia, SC 29201-2922
Mailing address
1415 Blanding St
Suite 4
Columbia, SC 29201-2922
Phone (803) 779-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 058163 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100706000052 | SC | Practitioner - Psychiatry | 1153452263 | Practice locations: Columbia, SC |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- University of Michigan Homeopathic Medical School, 1961
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1415 Blanding St
Suite 4
Columbia, SC 29201-2922
Phone 803779750040
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5816 | SC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437696000000",
"number": "1548240484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1415 BLANDING ST",
"address_2": "SUITE 4",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292012922",
"telephone_number": "803-779-7500",
"fax_number": "803-779-7522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 BLANDING ST",
"address_2": "SUITE 4",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292012922",
"telephone_number": "803-779-7500",
"fax_number": "803-779-7522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHNACKENBERG",
"first_name": "ROBERT",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-18",
"last_updated": "2015-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "SC",
"license": "5816",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "SC",
"license": "5816",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "058163",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.