NPIMap

Individual provider Active NPI

James Edward Schramm, PA-C

  • Physician Assistant
  • Coos Bay, OR
National Provider Identifier
1821216284
Registry record updated Nov 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01254 Issued in OR
Practice address
1620 Thompson Rd.
Coos Bay, OR 97420-2150
Phone
(541) 269-2986
Fax
(541) 269-7987
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 00070001 WA
Physician Assistant 363A00000X PA10003531 WA
Physician Assistant 363A00000X PA01254 OR Primary

Addresses

Primary practice location

1620 Thompson Rd.
Coos Bay, OR 97420-2150

Mailing address

1620 Thompson Rd.
Coos Bay, OR 97420-2150
Phone (541) 269-2986

Other identifiers 1

IdentifierTypeStateIssuer
0211516OtherWALABOR & INDUSTRIES #

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

State licenses

LicenseStateTypeSpecialty
RN 00070001WAMDRegistered Nurse
PA10003531WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icco, LLC Past Accepting new patients
South Coast Hospice & Palliative Care Services Inc Past Accepting new patients
Palliative Care Services, Inc. Physician Assistant Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226361600000",
    "number": "1821216284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 THOMPSON RD.",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202150",
            "telephone_number": "541-269-2986",
            "fax_number": "541-269-7987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 THOMPSON RD.",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202150",
            "telephone_number": "541-269-2986",
            "fax_number": "541-269-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRAMM",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2008-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN 00070001",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003531",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES #",
            "identifier": "0211516",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; 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.