J David Schaefer MD PLLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

230224-1 Issued in NY

Legal business name

J DAVID SCHAEFER MD PLLC

Practice address

3 Lyon Place
Ste 302
Ogdensburg, NY 13669

Phone

(315) 393-7955

Fax

(315) 393-7927

NPI assigned

Jun 21, 2006

Organization subpart

No

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

Authorized official

Name

John David Schaefer, M.D.

Title

Owner

Phone

(315) 393-7955

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280793600000",
    "number": "1851337331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LYON PLACE",
            "address_2": "STE 200",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "13669",
            "telephone_number": "315-393-7955",
            "fax_number": "315-393-7927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 LYON PLACE",
            "address_2": "STE 302",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "13669",
            "telephone_number": "315-393-7955",
            "fax_number": "315-393-7927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J DAVID SCHAEFER MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2010-08-03",
        "status": "A",
        "authorized_official_last_name": "SCHAEFER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-393-7955",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "230224-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02524436",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tuan Huynh
• Jamie William Hynd, M.D.
• Laura Michelle Irvine, NPP
• Malika T Ismaily
• Zachary John Holley Ives, NYS PEER SPECIALIST
• Natalie Lynn Jackson, PHARMD
• John J Jacobson, MD
• Manasvi Jaitly, MD
• Adam D Jarrett, M.D.
• Alyssa Joye Jenkins

• Otolaryngology Physician in Ogdensburg, NY
• Providers in Ogdensburg, NY by specialty
• Otolaryngology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; 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.