Individual provider Active NPI

Jennifer Schell, DO

  • Pediatrics Physician
  • Traverse City, MI
National Provider Identifier
1952402653
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
JS011520 Issued in MI
Practice address
4020 W Royal Dr
Traverse City, MI 49684-8965
Phone
(231) 421-8099
Fax
(231) 421-8599
NPI assigned
Sep 26, 2006
Last updated
Jul 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X JS011520 MI Primary

Addresses

Primary practice location

4020 W Royal Dr
Traverse City, MI 49684-8965

Mailing address

4020 W Royal Dr
Traverse City, MI 49684-8965
Phone (231) 421-8099

Other identifiers 1

IdentifierTypeStateIssuer
4350301MedicaidMI

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
JS011520MIMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: jschell@tapac.opdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311811200000",
    "number": "1952402653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 W ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848965",
            "telephone_number": "231-421-8099",
            "fax_number": "231-421-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 W ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848965",
            "telephone_number": "231-421-8099",
            "fax_number": "231-421-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHELL",
        "first_name": "JENNIFER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2011-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "JS011520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4350301",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; 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.