Individual provider Active NPI

Christine Lynn Schroeder, PA-C

  • Medical Physician Assistant
  • Chesterfield, MO
National Provider Identifier
1922535798
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2017004565 Issued in MO
Practice address
17300 North Outer 40 Rd Ste 201
Chesterfield, MO 63005-1364
Phone
(636) 778-2900
Fax
(636) 778-2828
NPI assigned
May 11, 2017
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2017004565 MO Primary

Addresses

Primary practice location

17300 North Outer 40 Rd Ste 201
Chesterfield, MO 63005-1364

Mailing address

17300 North Outer 40 Rd Ste 201
Chesterfield, MO 63005-1364
Phone (636) 778-2900

Other names 1

  • Christine L Robison Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bluetail Medical Group, LLC. CurrentSince Jun 24, 2017 Accepting new patients

Locations

13353 Olive Blvd
Chesterfield, MO 63017
Phone (314) 200-4955

17300 North Outer 40 Rd
Ste 201
Chesterfield, MO 63005
Phone (636) 778-2815

160 Westmount Dr
Farmington, MO 63640
Phone (573) 701-0770

Interoperability endpoints

  • Direct secure messaging: christine.schroeder.1@5924.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1922535798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17300 NORTH OUTER 40 RD STE 201",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051364",
            "telephone_number": "636-778-2900",
            "fax_number": "636-778-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 NORTH OUTER 40 RD STE 201",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051364",
            "telephone_number": "636-778-2900",
            "fax_number": "636-778-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "CHRISTINE",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2017004565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "ROBISON",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.