DR. ERIC OTTO SHREDER (NPI# 1982712519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982712519 |
| Entity Type | Individual |
| Full Name | DR. ERIC OTTO SHREDER |
| Credential | D.O. |
| Practice Address |
4838 E Baseline Rd Suite 103 Mesa AZ 85206-4671 |
| Practice Telephone | 4809268000 |
| Practice Fax Number | 4809263445 |
| Mailing Telephone | 4809268000 |
| Mailing Fax Number | 4809263445 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2010-06-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | DO3456 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | BCBS | AZ071-6830 | 01 |
| AZ | AHCCCS | 973281 | 01 |
| AZ | HEALTHNET | 2Z3699 | 01 |
| Street Address |
4838 E BASELINE RD SUITE 103 |
| City | MESA |
| State | AZ |
| Zip Code | 85206-4671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992704266 | Hezekiah Ubochi Chinwah | Internal Medicine | 4838 E Baseline Rd, Bldg. 2 Ste. 110, Mesa, AZ 85206-4671 | 2005-07-19 |
| 1053824631 | Integrated Pain Consultants, LLC | Pain Medicine | 4838 E Baseline Rd, Bldg 2 Suite 109, Mesa, AZ 85206-4671 | 2017-11-06 |
| 1689123960 | Sara Marie Brown | Nurse Anesthetist, Certified Registered | 4838 E Baseline Rd, Ste. 108, Mesa, AZ 85206-4671 | 2016-09-27 |
| 1669805354 | Tabitha C Parent-buck | Audiologist | 4838 E Baseline Rd, Suite 126, Mesa, AZ 85206-4671 | 2013-08-16 |
| 1104167154 | Pierpont Family Medicine | Family Medicine | 4838 E Baseline Rd, Suite 103, Mesa, AZ 85206-4671 | 2013-03-14 |
| 1669716783 | Susan Bazzell, Md, Pllc | Anesthesiology | 4838 E Baseline Rd, Suite 108, Mesa, AZ 85206-4671 | 2012-11-15 |
| 1851656771 | Michael Givens Jr. | Physical Medicine & Rehabilitation | 4838 E Baseline Rd, Bldg 2, Suite 109, Mesa, AZ 85206-4672 | 2012-07-06 |
| 1912208430 | Sarah Derubeis | Nurse Practitioner | 4838 E Baseline Rd, #103, Mesa, AZ 85206-4671 | 2010-11-15 |
| 1851608129 | Cameron Hay Moskos | Physician Assistant | 4838 E Baseline Rd, #103, Mesa, AZ 85206-4671 | 2010-09-08 |
| 1336451707 | Arizona Cardiovascular Associates LLC | Internal Medicine | 4838 E Baseline Rd, Suite 104, Mesa, AZ 85206-4671 | 2010-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
| 1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
| 1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
| 1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
| 1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
| 1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
| 1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
| 1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
| 1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
| 1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
| Find all providers in zip 85206 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649884065 | Miranda Gamgah Njante | Family Medicine | 10445 E Pivitol Ave, Mesa, AZ 85212-8037 | 2020-09-02 |
| 1457987679 | Az Med 4u | Family Medicine | 1136 E Harmony Ave Ste 101, Mesa, AZ 85204-5844 | 2020-03-19 |
| 1619500089 | Elizabeth Lapioli | Family Medicine | 5422 S St Claire, Mesa, AZ 85212-5420 | 2020-02-13 |
| 1003448952 | M.g.t Rn LLC | Family Medicine | 7117 E Peralta Cir, Mesa, AZ 85212-9825 | 2020-02-09 |
| 1144793126 | Health and Wellness Clinic LLC | Family Medicine | 1155 S Country Club Dr, Mesa, AZ 85210-4615 | 2019-01-02 |
| 1013487800 | Akos Live | Family Medicine | 1902 W. Main Street, Mesa, AZ 85201 | 2018-12-05 |
| 1447725189 | Adam Craig Turner | Family Medicine | 925 N Nina Dr, Mesa, AZ 85201-3935 | 2018-10-09 |
| 1235620170 | Stephanie Deborah Kotsur | Family Medicine | 7334 E Plata Ave, Mesa, AZ 85212-9754 | 2018-05-26 |
| 1902308042 | Andrew Jason Wood | Family Medicine | 10902 E Sunland Ave, Mesa, AZ 85208-3938 | 2018-03-05 |
| 1871002683 | Verve Wellness Center, LLC. | Family Medicine | 4838 E Baseline Rd Ste 110, Mesa, AZ 85206-4674 | 2017-09-25 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.