Individual provider Active NPI

Jack Joseph Schneider, M.D.

  • Therapeutic Radiology Physician
  • Naples, FL
National Provider Identifier
1720043649
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Therapeutic Radiology PhysicianTaxonomy code 2085R0203X
License
13423 Issued in FL
Practice address
6361 Pelican Bay Blvd
Apt. 1205
Naples, FL 34108-7134
Phone
(239) 566-9194
Fax
(239) 514-2989
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Therapeutic Radiology Physician 2085R0203X 13423 FL Primary

Addresses

Primary practice location

6361 Pelican Bay Blvd
Apt. 1205
Naples, FL 34108-7134

Mailing address

6361 Pelican Bay Blvd
Apt. 1205
Naples, FL 34108-7134
Phone (239) 566-9194

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13423FLMDPastoral Counselor

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1720043649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6361 PELICAN BAY BLVD",
            "address_2": "APT. 1205",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341087134",
            "telephone_number": "239-566-9194",
            "fax_number": "239-514-2989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6361 PELICAN BAY BLVD",
            "address_2": "APT. 1205",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341087134",
            "telephone_number": "239-566-9194",
            "fax_number": "239-514-2989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "JACK",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "FL",
            "license": "13423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; 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.