Active NPI
Jennifer L Schrader, FNP
- Family Nurse Practitioner
- Utica, NY
National Provider Identifier
1639504897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 338089
- Practice address
- 120 Hobart St
Utica, NY 13501-4308 - Phone
- (315) 798-1149
- Fax
- (315) 734-3565
- NPI assigned
- Sep 6, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 537821 | NY | |
| Family Nurse Practitioner | 363LF0000X | 338089 | NY | Primary |
Addresses
Primary practice location
120 Hobart St
Utica, NY 13501-4308
Mailing address
120 Hobart St
Utica, NY 13501-4308
Phone (315) 798-1149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250327001585 | NY | Order and Referring Only - Nurse Practitioner | 6305075862 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 537821 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392076800000",
"number": "1639504897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 HOBART ST",
"city": "UTICA",
"state": "NY",
"postal_code": "135014308",
"telephone_number": "315-798-1149",
"fax_number": "315-734-3565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 HOBART ST",
"city": "UTICA",
"state": "NY",
"postal_code": "135014308",
"telephone_number": "315-798-1149",
"fax_number": "315-734-3565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHRADER",
"first_name": "JENNIFER",
"middle_name": "L",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-06",
"last_updated": "2014-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "537821",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "338089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Utica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.