Active NPI
Walter L. Schmalstieg Jr., M.D.
- Child & Adolescent Psychiatry Physician
- Ooltewah, TN
National Provider Identifier
1740209683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 9600042
- Practice address
- 2615 Copper CV
Ooltewah, TN 37363-3002 - Phone
- (704) 609-6885
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 9600042 | NC | Primary |
Addresses
Primary practice location
2615 Copper CV
Ooltewah, TN 37363-3002
Mailing address
2615 Copper CV
Ooltewah, TN 37363-3002
Phone (704) 609-6885
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740209683 | Medicaid | NC | |
| N0004D | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9600042 | NC | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Low Country Health Care System, Inc | Current | Accepting new patients | |
| Low Country Health Care System, Inc | Current | Accepting new patients | |
| Low Country Health Care System, Inc. | Current | Accepting new patients | |
| Spindletop MHMR Services | Current | Accepting new patients | |
| Spindletop MHMR Services | Current | Accepting new patients | |
| South Carolina Dept of Mental Health Accounting Office | Current | Accepting new patients | |
| South Carolina Dept of Mental Health Accounting Office | Current | Accepting new patients | |
| Resolutions Counseling and Mediation Services, PLLC | Past | Accepting new patients | |
| Carolina Psychological and Psychiatric Health SRVS, PA | Past | Accepting new patients |
Locations
86 Wren St
Barnwell, SC 29812
Phone (803) 259-5762
164 Waccamaw Medical Park Dr
Conway, SC 29526
Phone (843) 347-4888
333 Revolutionary Trl
Fairfax, SC 29827
Phone (803) 632-2533
2750 S 8th St
Beaumont, TX 77701
Phone (409) 838-6203
Organizations & group practices 9
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.
-
- Federally Qualified Health Center (FQHC)
- Farifax, SC
- NPI 1053475566
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Conway, SC
- NPI 1356397228
-
- Family Medicine Physician
- Beaumont, TX
- NPI 1952357550
-
- Federally Qualified Health Center (FQHC)
- Fairfax, SC
- NPI 1649366022
-
- Federally Qualified Health Center (FQHC)
- Aiken, SC
- NPI 1194288571
-
- Community/Behavioral Health Agency
- Columbia, SC
- NPI 1083421994
-
- Mental Health Counselor
- Beaumont, TX
- NPI 1467517656
-
- Psychologist
- Jacksonville, NC
- NPI 1770561193
-
- Clinical Social Worker
- Jacksonville, NC
- NPI 1982868501
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700006400000",
"number": "1740209683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2615 COPPER CV",
"city": "OOLTEWAH",
"state": "TN",
"postal_code": "373633002",
"telephone_number": "704-609-6885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2615 COPPER CV",
"city": "OOLTEWAH",
"state": "TN",
"postal_code": "373633002",
"telephone_number": "704-609-6885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHMALSTIEG",
"first_name": "WALTER",
"middle_name": "L.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2023-11-15",
"certification_date": "2023-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NC",
"license": "9600042",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1740209683",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N0004D",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ooltewah, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.