Individual provider Active NPI

Larry C Schramm, MD

  • Internal Medicine Physician
  • Winslow, AZ
National Provider Identifier
1902936438
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A053755 Issued in CA
Practice address
500 Indiana Ave
Winslow, AZ 86047-2169
Phone
(928) 289-4646
Fax
(928) 289-6290
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A053755 CA Primary

Addresses

Primary practice location

500 Indiana Ave
Winslow, AZ 86047-2169

Mailing address

500 Indiana Ave
Winslow, AZ 86047-2169
Phone (928) 289-4646

Other identifiers 1

IdentifierTypeStateIssuer
409236MedicaidAZ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110208000165 TX Practitioner - Internal MedicinePractitioner - General Practice 8729268867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 Indiana Ave
Winslow, AZ 86047-2169

500 N Indiana Ave
Winslow, AZ 86047-2169
Phone (928) 289-4646

SWC Navajo Route 15 and 60
1 Medical Center Dr
Dilkon, AZ 86047-2169
Phone (928) 289-4646

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
53755CAMDDentist
A053755CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dilkon Medical Center Current Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Sep 1, 2002 Accepting new patients
Winslow Indian Health Care Center, Inc Current Accepting new patients
Winslow Indian Health Care Group CurrentSince Sep 1, 2002 Accepting new patients
Winslow Indian Health Care Center, Inc Past Accepting new patients

Locations

500 Indiana Ave
Winslow, AZ 86047

826 W Desmond St
Winslow, AZ 86047
Phone (928) 289-4678

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1902936438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 INDIANA AVE",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "860472169",
            "telephone_number": "928-289-4646",
            "fax_number": "928-289-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 INDIANA AVE",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "860472169",
            "telephone_number": "928-289-4646",
            "fax_number": "928-289-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRAMM",
        "first_name": "LARRY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A053755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "409236",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winslow, AZ

Sources for this page

Verify at the official NPI Registry.