Yvonne Marie Sculley, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

MD181252 Issued in OR

Practice address

301 Fisher St
Keesler Afb, MS 39534-2508

Phone

(228) 376-4118

NPI assigned

Feb 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• WA PPO C-SNP
• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

• Direct secure messaging: ysculley351523@direct.peacehealth.org
• Direct secure messaging: yvonne.sculley.1@1814.direct.athenahealth.com
• Direct secure messaging: ysculleyagency238422@samhealth.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peacehealth

  • Multi-Specialty Clinic/Center
  • Florence, OR
  • NPI 1982774378
  Medicare reassignment NPD
• Peacehealth

  • Critical Access Hospital
  • Florence, OR
  • NPI 1578552402
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1013989474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 FISHER ST",
            "city": "KEESLER AFB",
            "state": "MS",
            "postal_code": "395342508",
            "telephone_number": "228-376-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 FISHER ST",
            "city": "KEESLER AFB",
            "state": "MS",
            "postal_code": "395342508",
            "telephone_number": "228-376-4118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3640 NW Samaritan Dr Ste 220",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303784",
            "country_code": "US",
            "telephone_number": "541-768-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCULLEY",
        "first_name": "YVONNE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD181252",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A70762",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ysculleycontractstaff215608@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3640 NW Samaritan Dr Ste 220",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amanda Marie Rust, PHARMD
• James Erwin Rux, O.D.
• James Ryan Saelens, MD
• Gregory Thomas Schandler, MD
• Amanda Lynn Schoth, RDH
• Brandon Terry Sellers, MD
• Miriam Seville, RD, CSSD
• Gregg Stephen Silberg, D.O.
• Benjamin Probie Smith, M.D.
• Justin Scott Smith, DNP, CRNA

• Obstetrics & Gynecology Physician in Keesler Afb, MS
• Providers in Keesler Afb, MS by specialty
• Obstetrics & Gynecology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.