NPIMap

Individual provider Active NPI

Shannon Ray Schrader, MD

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1629056304
Registry record updated Dec 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H8386 Issued in TX
Practice address
4101 Greenbriar St
#200
Houston, TX 77098-5294
Phone
(713) 526-7736
Fax
(713) 524-3155
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H8386 TX Primary

Addresses

Primary practice location

4101 Greenbriar St
#200
Houston, TX 77098-5294

Mailing address

2211 Norfolk St
Ste 1050
Houston, TX 77098-4044
Phone (713) 526-7736

Other identifiers 3

IdentifierTypeStateIssuer
45D1034404OtherTXCLIA
136386304MedicaidTX
8H3095OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111118000223 TX Practitioner - Family Practice 0547291221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisville Medical College, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2211 Norfolk St
Suite 1050
Houston, TX 77098-4044
Phone (713) 526-7736

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H8386TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Schrader Clinic, P.a. Family Medicine CurrentSince Jul 1, 2003 Accepting new patients
Michael K Crossley, M D P a Family Medicine Past Accepting new patients

Locations

2211 Norfolk St
Ste 1050
Houston, TX 77098
Phone (713) 526-1717

4101 Greenbriar Dr
Ste 200
Houston, TX 77098
Phone (713) 520-5537

Interoperability endpoints

  • Direct secure messaging: shannon.schrader.1@13512.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1629056304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 NORFOLK ST",
            "address_2": "STE 1050",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770984044",
            "telephone_number": "713-526-7736",
            "fax_number": "713-524-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 GREENBRIAR ST",
            "address_2": "#200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770985294",
            "telephone_number": "713-526-7736",
            "fax_number": "713-524-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRADER",
        "first_name": "SHANNON",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H8386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D1034404",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136386304",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8H3095",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.