Active NPI
Gary M Schneider, DO
- Internal Medicine Physician
- Madison, MS
National Provider Identifier
1922254531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 21564
- Practice address
- 125 Fenwick Cir
Madison, MS 39110-7783 - Phone
- (205) 807-4279
- Fax
- (209) 290-3015
- NPI assigned
- Aug 14, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 5101025823 | MI | |
| Internal Medicine Physician | 207R00000X | 163395 | AK | |
| Internal Medicine Physician | 207R00000X | 21564 | MS | Primary |
| Internal Medicine Physician | 207R00000X | 34.00974 | OH |
Addresses
Primary practice location
125 Fenwick Cir
Madison, MS 39110-7783
Mailing address
125 Fenwick Cir
Madison, MS 39110-7783
Phone (205) 807-4279
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS, IN
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 163395 | AK | MD | Internal Medicine Physician |
| 21564 | MS | MD | Internal Medicine Physician |
| 34.00974 | OH | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Careplus Lakeview Family Medicine | Current | Accepting new patients | |
| River Oaks Management Company LLC | Internal Medicine | Current | Accepting new patients |
| River Oaks Management Company | Internal Medicine | Current | Accepting new patients |
| Reservoir Family Medical Clinic, PA | Current | Accepting new patients | |
| Reliantmd Telehealth Group PLLC | Internal Medicine | Past | Accepting new patients |
| Peter J Jensen MD PC | Past | Accepting new patients |
Locations
350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500
5903 Ridgewood Rd
Jackson, MS 39211
Phone (601) 376-2022
Interoperability endpoints
- https://api.platform.athenahealth.com/7115/brand/1/csg/1/fhir/r4
Organizations & group practices 6
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.
-
- Family Medicine Physician
- Jackson, MS
- NPI 1922029040
Internal Medicine
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- Clinton, MS
- NPI 1942621024
-
- Family Medicine Physician
- Flowood, MS
- NPI 1770929713
-
dba Comprehensive Weight Management Center
- Internal Medicine Physician
- Jackson, MS
- NPI 1841437654
-
- Family Medicine Physician
- Florence, AL
- NPI 1629177027
-
- Family Medicine Physician
- Austin, TX
- NPI 1447827456
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611014400000",
"number": "1922254531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 FENWICK CIR",
"city": "MADISON",
"state": "MS",
"postal_code": "391107783",
"telephone_number": "205-807-4279",
"fax_number": "209-290-3015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 FENWICK CIR",
"city": "MADISON",
"state": "MS",
"postal_code": "391107783",
"telephone_number": "205-807-4279",
"fax_number": "209-290-3015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHNEIDER",
"first_name": "GARY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-08-14",
"last_updated": "2021-01-19",
"certification_date": "2021-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "5101025823",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AK",
"license": "163395",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MS",
"license": "21564",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "34.00974",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Madison, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.