Individual provider Active NPI

William Richard Schoberg, RN

  • General Practice Registered Nurse
  • Minneapolis, MN
National Provider Identifier
1689884124
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
R106736-9 Issued in MN
Practice address
2825 1St Ave S
Minneapolis, MN 55408-2351
Phone
(612) 874-7628
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X R106736-9 MN Primary

Addresses

Primary practice location

2825 1St Ave S
Minneapolis, MN 55408-2351

Mailing address

2825 1St Ave S
Minneapolis, MN 55408-2351
Phone (612) 874-7628

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R106736-9MNMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1689884124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 1ST AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082351",
            "telephone_number": "612-874-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 1ST AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082351",
            "telephone_number": "612-874-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOBERG",
        "first_name": "WILLIAM",
        "middle_name": "RICHARD",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MN",
            "license": "R106736-9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; 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.