Individual provider Active NPI

Michael David Schall I, O.D.

  • Optometrist
  • North Charleston, SC
National Provider Identifier
1639175987
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
524 Issued in SC
Practice address
1415 Remount Rd
North Charleston, SC 29406-3326
Phone
(843) 554-7554
Fax
(843) 554-7550
NPI assigned
Jun 22, 2005
Reactivated
Mar 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 524 SC Primary

Addresses

Primary practice location

1415 Remount Rd
North Charleston, SC 29406-3326

Mailing address

1415 Remount Rd
North Charleston, SC 29406-3326
Phone (843) 554-7554

Other identifiers 1

IdentifierTypeStateIssuer
DA9962MedicaidSC

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

State licenses

LicenseStateTypeSpecialty
524SCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael D. Schall, OD, PA Optometrist PastSince Mar 13, 1997 Accepting new patients

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639175987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 REMOUNT RD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294063326",
            "telephone_number": "843-554-7554",
            "fax_number": "843-554-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 REMOUNT RD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294063326",
            "telephone_number": "843-554-7554",
            "fax_number": "843-554-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHALL",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9962",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.