Individual provider Active NPI

Jo Ann Schroeder, C.N.P.

  • Primary Care Nurse Practitioner
  • Holloman Afb, NM
National Provider Identifier
1679756910
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
CNP01373 Issued in NM
Practice address
49TH Medical Group/SGPF
280 First St BLDG 23
Holloman Afb, NM 88330-8273
Phone
(575) 572-4889
Fax
(575) 572-2259
NPI assigned
Dec 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R57915 NM
Adult Health Nurse Practitioner 363LA2200X CNP01373 NM
Primary Care Nurse Practitioner 363LP2300X CNP01373 NM Primary

Addresses

Primary practice location

49TH Medical Group/SGPF
280 First St BLDG 23
Holloman Afb, NM 88330-8273

Mailing address

49TH Medical Group/SGPF
280 First Street, BLDG 23
Holloman Afb, NM 88330-8273
Phone (575) 572-4889

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
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R57915NMMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Mexico Heart Institute, LLC Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1679756910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49TH MEDICAL GROUP/SGPF",
            "address_2": "280 FIRST STREET, BLDG 23",
            "city": "HOLLOMAN AFB",
            "state": "NM",
            "postal_code": "883308273",
            "telephone_number": "575-572-4889",
            "fax_number": "575-572-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49TH MEDICAL GROUP/SGPF",
            "address_2": "280 FIRST ST BLDG 23",
            "city": "HOLLOMAN AFB",
            "state": "NM",
            "postal_code": "883308273",
            "telephone_number": "575-572-4889",
            "fax_number": "575-572-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "JO",
        "middle_name": "ANN",
        "credential": "C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-10",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "R57915",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "CNP01373",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NM",
            "license": "CNP01373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holloman Afb, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.