Individual provider Active NPI

Mark Joseph Scherlie, DO

  • Family Medicine Physician
  • Salem, OR
National Provider Identifier
1043210719
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO16682 Issued in OR
Practice address
1275 Wallace Rd NW
Salem, OR 97304
Phone
(503) 371-3232
Fax
(503) 375-2398
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO16682 OR Primary

Addresses

Primary practice location

1275 Wallace Rd NW
Salem, OR 97304

Mailing address

1275 Wallace Rd NW
Salem, OR 97304
Phone (503) 371-3232

Other identifiers 1

IdentifierTypeStateIssuer
45067MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
16682ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1043210719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 WALLACE RD NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97304",
            "telephone_number": "503-371-3232",
            "fax_number": "503-375-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 WALLACE RD NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97304",
            "telephone_number": "503-371-3232",
            "fax_number": "503-375-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHERLIE",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO16682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45067",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.