Individual provider Active NPI

Mark Donald Schellhammer, D.O.

  • Specialist
  • Ocoee, FL
National Provider Identifier
1568567766
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OS0006516 Issued in FL
Practice address
1555 Boren Dr
Ocoee, FL 34761-2989
Phone
(407) 292-2156
Fax
(407) 241-2868
NPI assigned
Sep 13, 2006
Last updated
Dec 31, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X OS0006516 FL Primary

Addresses

Primary practice location

1555 Boren Dr
Ocoee, FL 34761-2989

Mailing address

1555 Boren Dr
Ocoee, FL 34761-2989
Phone (407) 292-2156

Other identifiers 3

IdentifierTypeStateIssuer
2079783OtherAETNA PPO
378178000MedicaidFL
57273OtherFLBCBS - FL

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
OS0006516FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Center for Orthopaedic Inc PastSince Nov 23, 2010 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1337/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1568567766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 BOREN DR",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347612989",
            "telephone_number": "407-292-2156",
            "fax_number": "407-241-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 BOREN DR",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347612989",
            "telephone_number": "407-292-2156",
            "fax_number": "407-241-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHELLHAMMER",
        "first_name": "MARK",
        "middle_name": "DONALD",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "OS0006516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "2079783",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378178000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - FL",
            "identifier": "57273",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; 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.