Provider Demographics
NPI:1558396754
Name:SCHOONOVER, LINDA J (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:SCHOONOVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:280 CHESTUT ST
Mailing Address - Street 2:2ND FL
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:40 WRIGHT STREET
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069-1138
Practice Address - Country:US
Practice Address - Phone:413-370-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51739207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
772519OtherCONNECTICARE
101971OtherCIGNA
110123284OtherRAILROAD MEDICARE
70700OtherHARVARD PILGRIM
D16778Medicare UPIN
J02921Medicare ID - Type Unspecified
1293958OtherFALLON COMMUNITY HEALTH P
MAJ02921OtherBLUE CROSS BLUE SHIELD
MA6178138Medicaid
051739OtherTUFTS COMMUNITY HEALTH PL
439710OtherHEALTHSOURCE CMHC
0401568OtherUNITED HEALTH CARE
984979OtherNETWORK HEALTH