NPIMap

Individual provider Active NPI

Christine Schaefer, DO

  • Surgery Physician
  • Fort Collins, CO
National Provider Identifier
1962454223
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
12247 Issued in NH
Practice address
222 Jackson Ave
Fort Collins, CO 80521-2445
Phone
(970) 495-0267
Fax
(561) 209-0323
NPI assigned
May 16, 2006
Last updated
Dec 3, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 12247 NH Primary
Surgery Physician 208600000X 38684 CO

Addresses

Primary practice location

222 Jackson Ave
Fort Collins, CO 80521-2445

Mailing address

222 Jackson Ave
Fort Collins, CO 80521-2445
Phone (970) 495-0267

Other identifiers 1

IdentifierTypeStateIssuer
83188266MedicaidCO

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
38684COMDSurgery Physician
12247NHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Grayling Past Accepting new patients
Banner Greeley Specialists Past Accepting new patients
DHHS PHS Naihs Fort Defiance Hospital Past Accepting new patients
Mercy Professional Services Past Accepting new patients

Organizations & group practices 4

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1962454223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 JACKSON AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805212445",
            "telephone_number": "970-495-0267",
            "fax_number": "561-209-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 JACKSON AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805212445",
            "telephone_number": "970-495-0267",
            "fax_number": "561-209-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "CHRISTINE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NH",
            "license": "12247",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "38684",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83188266",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; 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.