Organization Active NPI

Dr Douglas C Shoenberger, PC

  • Family Medicine Physician
  • Coopersburg, PA
National Provider Identifier
1790902427
Registry record updated Mar 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD044386E Issued in PA
Legal business name
DR DOUGLAS C SHOENBERGER, PC
Practice address
101 S Main St
Suite 101
Coopersburg, PA 18036-1912
Phone
(610) 282-1170
Fax
(610) 282-0256
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2013

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

Authorized official

Name
Amber L Wuesthoff
Title
Office Manager
Phone
(610) 282-1170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD044386E PA Primary

Addresses

Primary practice location

101 S Main St
Suite 101
Coopersburg, PA 18036-1912

Mailing address

101 S Main St
Suite 101
Coopersburg, PA 18036-1912
Phone (610) 282-1170

Other identifiers 1

IdentifierTypeStateIssuer
1198777MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100413000016 PA Part B Supplier - Clinic/Group Practice 7810023363 Receives reassigned benefits from 7 practitioners
Practice locations: Coopersburg, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364169600000",
    "number": "1790902427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "address_2": "SUITE 101",
            "city": "COOPERSBURG",
            "state": "PA",
            "postal_code": "180361912",
            "telephone_number": "610-282-1170",
            "fax_number": "610-282-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "address_2": "SUITE 101",
            "city": "COOPERSBURG",
            "state": "PA",
            "postal_code": "180361912",
            "telephone_number": "610-282-1170",
            "fax_number": "610-282-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DOUGLAS C SHOENBERGER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2013-03-25",
        "status": "A",
        "authorized_official_last_name": "WUESTHOFF",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "610-282-1170"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD044386E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1198777",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coopersburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.