NPIMap

Individual provider Active NPI

Glenn Phillip Schoettle Jr., M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Memphis, TN
National Provider Identifier
1710996624
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD0000008085 Issued in TN
Practice address
6005 Park Ave
Suite 802
Memphis, TN 38119-5202
Phone
(901) 236-0508
Fax
(901) 682-2143
NPI assigned
Aug 7, 2006
Last updated
Oct 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD0000008085 TN Primary

Addresses

Primary practice location

6005 Park Ave
Suite 802
Memphis, TN 38119-5202

Mailing address

6005 Park Ave
Suite 802
Memphis, TN 38119-5202
Phone (901) 236-0508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070830000644 TN Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 0941393383 Reassigns benefits to 1 organization
I20260615003383 AR Practitioner - Thoracic Surgery 0941393383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Cardiac Surgery
Education
University of Tennessee, HSC, College of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Physician Network, LLCGroup PAC ID 2365701943, 74 clinicians

Practice addresses (Care Compare)

6005 Park Ave
Suite 802
Memphis, TN 38119-5218
Phone (901) 236-0508

628 Hospital Dr
E 1
Mountain Home, AR 72653-2953
Phone (870) 425-3291

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.82 of 100Reported as group
Quality
69.44
Promoting interoperability
100
Improvement activities
40
Cost
83.28

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000008085TNMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
8085TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Blakney Current Accepting new patients
Saint Francis Physician Network, LLC CurrentSince Feb 5, 2018 Accepting new patients
Thoracic and Cardiovascular Surgery Association Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

6005 Park Ave
Ste 323B
Memphis, TN 38119
Phone (901) 756-6991

6005 Park Ave
Ste 405
Memphis, TN 38119
Phone (901) 683-4505

6005 Park Ave
Ste 601
Memphis, TN 38119
Phone (901) 680-9205

6005 Park Ave
Ste 802
Memphis, TN 38119
Phone (901) 236-0508

Interoperability endpoints

  • Direct secure messaging: glenn.schoettle.1@16700.direct.athenahealth.com
  • Direct secure messaging: gschoettle26409@mlh.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1710996624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE",
            "address_2": "SUITE 802",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195202",
            "telephone_number": "901-236-0508",
            "fax_number": "901-682-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE",
            "address_2": "SUITE 802",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195202",
            "telephone_number": "901-236-0508",
            "fax_number": "901-682-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOETTLE",
        "first_name": "GLENN",
        "middle_name": "PHILLIP",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TN",
            "license": "MD0000008085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.