Individual provider Active NPI

Maria Rose Schreck, D.O.

  • Family Medicine Physician
  • Whitehall, OH
National Provider Identifier
1689917098
Registry record updated Mar 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34-012468 Issued in OH
Practice address
4214 E Main St
Whitehall, OH 43213-3028
Phone
(614) 334-6903
NPI assigned
Apr 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34-012468 OH Primary

Addresses

Primary practice location

4214 E Main St
Whitehall, OH 43213-3028

Mailing address

55 N High St
New Albany, OH 43054-7099
Phone (614) 855-4878

Other practice location 1

55 N High St
New Albany, OH 43054-7099
Phone (614) 855-4878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161109001534 OH Practitioner - Family Practice 8325289754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Lighthouse Behavioral Health Solutions, LLCGroup PAC ID 4486089893, 14 clinicians

Practice addresses (Care Compare)

4000 E Main St
Columbus, OH 43213-2950
Phone (614) 334-6903

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34-012468OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Behavioral Health Solutions, LLC Family Medicine CurrentSince Sep 18, 2023 Accepting new patients

Locations

4000 E Main St
Whitehall, OH 43213
Phone 6143346903 ext. 1316

4214 E Main St
Whitehall, OH 43213
Phone (330) 334-6903

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": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710633600000",
    "number": "1689917098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 N HIGH ST",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430547099",
            "telephone_number": "614-855-4878",
            "fax_number": "614-855-4813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 E MAIN ST",
            "city": "WHITEHALL",
            "state": "OH",
            "postal_code": "432133028",
            "telephone_number": "614-334-6903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 N High St",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "OH",
            "postal_code": "430547099",
            "country_code": "US",
            "telephone_number": "614-855-4878",
            "fax_number": "614-855-4813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHRECK",
        "first_name": "MARIA",
        "middle_name": "ROSE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2024-03-17",
        "certification_date": "2024-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-012468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitehall, OH

Sources for this page

Verify at the official NPI Registry.