1144223025 NPI number — DR. TERESA J SCHUTTE M.D.

Table of content: DR. TERESA J SCHUTTE M.D. (NPI 1144223025)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144223025 NPI number — DR. TERESA J SCHUTTE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHUTTE
Provider First Name:
TERESA
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144223025
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6939 COX RD STE 350
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIBERTY TWP
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45069-7595
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-564-1600
Provider Business Mailing Address Fax Number:
513-564-1624

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6939 COX RD STE 350
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIBERTY TWP
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45069-7595
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-564-1600
Provider Business Practice Location Address Fax Number:
513-564-1624
Provider Enumeration Date:
05/24/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  35073852S , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 311575051034 . This is a "CARESOURCE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 280703289011 . This is a "MEDICAL MUTUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 7100242580 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0702029 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2022126 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 73852 . This is a "HUMANA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 160040699 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 288140 . This is a "AMERIGROUP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000021102 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2046726 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".