Jennifer Marie Scagliola, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036139550 Issued in IL

Practice address

117 E Clark St
Sih Medical Group Primary Care Harrisburg
Harrisburg, IL 62946-2702

Phone

(618) 252-8625

Fax

(618) 252-2540

NPI assigned

Jul 28, 2009

Last updated

Jan 11, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: jscagliola13665@sih.direct-ci.com

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1033340823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E CLARK ST",
            "address_2": "SIH MEDICAL GROUP PRIMARY CARE HARRISBURG",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462702",
            "telephone_number": "618-252-8625",
            "fax_number": "618-252-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E CLARK ST",
            "address_2": "SIH MEDICAL GROUP PRIMARY CARE HARRISBURG",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462702",
            "telephone_number": "618-252-8625",
            "fax_number": "618-252-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCAGLIOLA",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036139550",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "TL36714",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "275812",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2015-02018",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Harrisburg, IL
• Providers in Harrisburg, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.