Individual provider Active NPI

Magdalen Ann Schmudde, PN 058036

  • Licensed Practical Nurse
  • Cincinnati, OH
National Provider Identifier
1669618542
Registry record updated Dec 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
058036 Issued in OH
Practice address
5066 Sanro Dr
Cincinnati, OH 45244-1049
Phone
(513) 831-0430
Fax
(513) 831-1590
NPI assigned
Dec 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 058036 OH Primary

Addresses

Primary practice location

5066 Sanro Dr
Cincinnati, OH 45244-1049

Mailing address

5066 Sanro Dr
Cincinnati, OH 45244-1049
Phone (513) 831-0430

Other identifiers 1

IdentifierTypeStateIssuer
0836868MedicaidOH

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)
Not enrolled
Credentials
Advanced Practice Nurse

State licenses

LicenseStateTypeSpecialty
058036OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1230249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230249600000",
    "number": "1669618542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5066 SANRO DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452441049",
            "telephone_number": "513-831-0430",
            "fax_number": "513-831-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5066 SANRO DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452441049",
            "telephone_number": "513-831-0430",
            "fax_number": "513-831-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMUDDE",
        "first_name": "MAGDALEN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PN 058036",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-26",
        "last_updated": "2008-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "058036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0836868",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2008; 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.