MEDICARE: DR. TAMMY KAYE SCHRODT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	01055170A	IN
2	208000000X	Pediatrics Physician	35443	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	IN2570088	OTHER	IN	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000845602	OTHER	KY	ANTHEM-NCMA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	50061772	OTHER	KY	PASSPORT-NCMA
5	130986	OTHER	KY	SIH0-NCMA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518915271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAMMY KAYE SCHRODT M.D.

Provider Business Mailing Address
First Line	:	PO BOX 776879
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-6879
Country	:	US
Telephone Number	:	502-559-9337
Fax Number	:	502-272-5116

Provider Business Practice Location Address
First Line	:	5211 COMMERCE CROSSINGS DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40229-2183
Country	:	US
Telephone Number	:	502-966-3918
Fax Number	:	502-969-3665

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	04/04/2024

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