NPIMap

Individual provider Active NPI

Heather R Scullin, DO

  • Physical Medicine & Rehabilitation Physician
  • Lorain, OH
National Provider Identifier
1285608539
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
34006017 Issued in OH
Practice address
3700 Kolbe Rd
Lorain, OH 44053-1611
Phone
(440) 960-3470
Fax
(440) 960-4678
NPI assigned
Feb 14, 2006
Last updated
Jun 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 34006017 OH Primary

Addresses

Primary practice location

3700 Kolbe Rd
Lorain, OH 44053-1611

Mailing address

3700 Kolbe Rd
Lorain, OH 44053-1611
Phone (440) 960-3470

Other identifiers 3

IdentifierTypeStateIssuer
3025372MedicaidOH
2001569MedicaidOH
0236248MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081208000010 OH Practitioner - Physical Medicine and Rehabilitation 6204997448 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Ohio University, College of Osteopathic Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Lorain Specialty Care LLCGroup PAC ID 4688070055, 134 clinicians

Practice addresses (Care Compare)

3700 Kolbe Rd
Lorain, OH 44053-1611
Phone (440) 988-1009

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34006017OHMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Lorain, LLC CurrentSince Jan 1, 2014 Accepting new patients
Mercy Health Physicians Lorain Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians, Lorain, LLC CurrentSince Jan 1, 2014 Accepting new patients
Mercy Health Physicians Lorain Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health-Regional Medical Center LLC Past Accepting new patients

Locations

1957 Cooper Foster Park Rd
Amherst, OH 44001
Phone (440) 989-3801

578 N Leavitt Rd
Amherst, OH 44001
Phone (440) 960-3912

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

600 Kendal Dr
Oberlin, OH 44074
Phone (440) 775-0094

Interoperability endpoints

  • Direct secure messaging: hscullin41836@direct.bsmhealth.org

Organizations & group practices 5

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1285608539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 KOLBE RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531611",
            "telephone_number": "440-960-3470",
            "fax_number": "440-960-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 KOLBE RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531611",
            "telephone_number": "440-960-3470",
            "fax_number": "440-960-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLIN",
        "first_name": "HEATHER",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "34006017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3025372",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2001569",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0236248",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.