Active NPI
Mark Edward Schroeder, M.D.
- Internal Medicine Physician
- Niceville, FL
National Provider Identifier
1932174091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME0069073
- Practice address
- 1005 College Blvd W
Suite C
Niceville, FL 32578-1053 - Phone
- (850) 678-3994
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME0069073 | FL | Primary |
Addresses
Primary practice location
1005 College Blvd W
Suite C
Niceville, FL 32578-1053
Mailing address
1005 College Blvd W
Suite C
Niceville, FL 32578-1053
Phone (850) 678-3994
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0069073 | FL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192492800000",
"number": "1932174091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 COLLEGE BLVD W",
"address_2": "SUITE C",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325781053",
"telephone_number": "850-678-3994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 COLLEGE BLVD W",
"address_2": "SUITE C",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325781053",
"telephone_number": "850-678-3994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROEDER",
"first_name": "MARK",
"middle_name": "EDWARD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2007-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME0069073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Niceville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.