Walter A Schroeder Jr., DO MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MOR9980 Issued in MO

Practice address

3203 Blattner Drive
Cape Girardeau, MO 63703

Phone

(573) 334-5007

Fax

(573) 334-6369

NPI assigned

Sep 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

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.

• Doctors Park Surgery Inc

  • Ambulatory Surgical Clinic/Center
  • Cape Girardeau, MO
  • NPI 1861487324
  NPD

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811098312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 BLATTNER DRIVE",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "63703",
            "telephone_number": "573-334-5007",
            "fax_number": "573-334-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3203 BLATTNER DRIVE",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "63703",
            "telephone_number": "573-334-5007",
            "fax_number": "573-334-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "WALTER",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "DO MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "MOR9980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH LINK",
            "identifier": "119051",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "26757",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Ann Schoolman, D.D.S.
• Steven Ronald Schoolman, DDS
• Kyle J Schott, LPC
• Robert Schremp, P.T.
• Jennifer E Schroeder
• Sidney Leaanne Schrum
• Taylor Schubert, PTA
• Laura Ellen Schuch, M.A-SLP
• Connie Schuessler, LCSW
• Andrew Edward Schulman, CRNA

• Otolaryngology Physician in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Otolaryngology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.