Individual provider Active NPI

Chriselda Juanita Schroeder, CPNP

  • Pediatric Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1861744898
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
628526 Issued in TX
Practice address
3434 W Illinois Ave
Ste 306-3
Dallas, TX 75211-8709
Phone
(214) 623-1900
Fax
(214) 623-1901
NPI assigned
Oct 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 628526 TX Primary

Addresses

Primary practice location

3434 W Illinois Ave
Ste 306-3
Dallas, TX 75211-8709

Mailing address

3434 W Illinois Ave
Ste 306-3
Dallas, TX 75211-8709
Phone (214) 623-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240321003035 TX Order and Referring Only - Nurse Practitioner 0648617902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
628526TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Topcare Medical Group Inc Past Accepting new patients
Physicians for Children Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1861744898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 W ILLINOIS AVE",
            "address_2": "STE 306-3",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752118709",
            "telephone_number": "214-623-1900",
            "fax_number": "214-623-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 W ILLINOIS AVE",
            "address_2": "STE 306-3",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752118709",
            "telephone_number": "214-623-1900",
            "fax_number": "214-623-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "CHRISELDA",
        "middle_name": "JUANITA",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-15",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "628526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.