Ilene Schroeder, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY001104 Issued in GA

Practice address

675 Seminole Ave NE
Ste 107
Atlanta, GA 30307-3411

Phone

(404) 873-6840

Fax

(404) 881-8410

NPI assigned

Mar 15, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 3, 2015 through Mar 3, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1558495481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 SEMINOLE AVE NE",
            "address_2": "STE 107",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303073411",
            "telephone_number": "404-873-6840",
            "fax_number": "404-881-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 SEMINOLE AVE NE",
            "address_2": "STE 107",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303073411",
            "telephone_number": "404-873-6840",
            "fax_number": "404-881-8410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "ILENE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY001104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly D. Schrapp, M.D.
• Maggie Schreck, PA-C
• Robert D Schreiner, MD
• Ashleigh Nicole Schroder, CAA
• Harry William Schroeder III, MD, PHD
• Joseph Dennis Schroeder, R.P.A.
• Peggy Maxine Schroeder, CRNA
• Thomas Edward Schroeder
• Bobbi Jolene Schroederbeavers, LMSW
• Kelley Stephens Schroth, MD

• Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.