Individual provider Active NPI

Robert Alan Schoumacher, MD

  • Pediatric Pulmonology Physician
  • Grand Rapids, MI
National Provider Identifier
1942267505
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
4301503225 Issued in MI
Practice address
35 Michigan St NE Ste 3003
Grand Rapids, MI 49503-2528
Phone
(616) 267-2200
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 4301503225 MI Primary

Addresses

Primary practice location

35 Michigan St NE Ste 3003
Grand Rapids, MI 49503-2528

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Other practice location 1

1105 Sixth St
Traverse City, MI 49684-2345
Phone (231) 935-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101011000376 TN Practitioner - Pediatric Medicine 1951593813 Reassigns benefits to 1 organization
I20201005002938 MI Practitioner - Pediatric Medicine 1951593813 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301503225MIMDPediatric Pulmonology Physician
24330TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center CurrentSince Dec 13, 2022 Accepting new patients
Munson Medical Center CurrentSince Dec 13, 2022 Accepting new patients
Ut Lebonheur Pediatric Specialists, Inc. Pediatric Pulmonology CurrentSince Dec 1, 2010 Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

550 Munson Ave
Traverse City, MI 49686
Phone (231) 935-6600

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

1407 Union Ave
Ste 200
Memphis, TN 38104
Phone (901) 866-8360

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1942267505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MICHIGAN ST NE STE 3003",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032528",
            "telephone_number": "616-267-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 Sixth St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842345",
            "country_code": "US",
            "telephone_number": "231-935-6600",
            "fax_number": "231-935-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHOUMACHER",
        "first_name": "ROBERT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "MI",
            "license": "4301503225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.