Active NPI
Donald B. Schak Sr., M.D., PA
- Family Medicine Physician
- Valparaiso, FL
National Provider Identifier
1629092069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME76306
- Legal business name
- DONALD B. SCHAK SR., M.D., PA
- Practice address
- 120 S John Sims Pkwy
Suite C
Valparaiso, FL 32580-1212 - Phone
- (850) 678-0061
- Fax
- (850) 678-0068
- NPI assigned
- Jul 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Donald B. Schak Sr., M.D., PA
- Title
- Direct Owner
- Phone
- (850) 678-0061
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME76306 | FL | Primary |
Addresses
Primary practice location
120 S John Sims Pkwy
Suite C
Valparaiso, FL 32580-1212
Mailing address
120 S John Sims Pkwy
Suite C
Valparaiso, FL 32580-1212
Phone (850) 678-0061
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 256492100 | Medicaid | FL | |
| 44534 | Other | FL | BCBS |
| B288 | Other | FL | HEALTH OPTIONS |
National Provider Directory
National Provider DirectoryLocations
120 S John Sims Pkwy
Ste C
Valparaiso, FL 32580
Phone (850) 678-0061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1363132800000",
"number": "1629092069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 S JOHN SIMS PKWY",
"address_2": "SUITE C",
"city": "VALPARAISO",
"state": "FL",
"postal_code": "325801212",
"telephone_number": "850-678-0061",
"fax_number": "850-678-0068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 S JOHN SIMS PKWY",
"address_2": "SUITE C",
"city": "VALPARAISO",
"state": "FL",
"postal_code": "325801212",
"telephone_number": "850-678-0061",
"fax_number": "850-678-0068"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DONALD B. SCHAK SR., M.D., PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-27",
"last_updated": "2013-03-13",
"status": "A",
"authorized_official_last_name": "SCHAK",
"authorized_official_first_name": "DONALD",
"authorized_official_middle_name": "B.",
"authorized_official_title_or_position": "DIRECT OWNER",
"authorized_official_telephone_number": "850-678-0061",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Sr.",
"authorized_official_credential": "M.D., PA"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "FL",
"license": "ME76306",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "256492100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "44534",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH OPTIONS",
"identifier": "B288",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Valparaiso, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.