Individual provider Active NPI

Jennifer L Schrader, FNP

  • Family Nurse Practitioner
  • Utica, NY
National Provider Identifier
1639504897
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
338089 Issued in NY
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

Updated by the provider on Feb 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250327001585 NY Order and Referring Only - Nurse Practitioner 6305075862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
537821NYMDRegistered 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

Verify at the official NPI Registry.