Individual provider Active NPI

Daniel C Schackmann, MA LLP

  • Psychologist
  • Alpena, MI
National Provider Identifier
1922340199
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301007236 Issued in MI
Practice address
1501 W Chisholm St
Alpena, MI 49707-1401
Phone
(989) 356-7242
Fax
(989) 356-7320
NPI assigned
Mar 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301007236 MI Primary

Addresses

Primary practice location

1501 W Chisholm St
Alpena, MI 49707-1401

Mailing address

1501 W Chisholm St
Alpena, MI 49707-1401
Phone (989) 356-7242

Other identifiers 1

IdentifierTypeStateIssuer
6301007236OtherMIMI LICENSE

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1922340199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 W CHISHOLM ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071401",
            "telephone_number": "989-356-7242",
            "fax_number": "989-356-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W CHISHOLM ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071401",
            "telephone_number": "989-356-7242",
            "fax_number": "989-356-7320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHACKMANN",
        "first_name": "DANIEL",
        "middle_name": "C",
        "credential": "MA LLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301007236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI LICENSE",
            "identifier": "6301007236",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpena, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.