Dennis M Scully, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD017266E Issued in PA

Practice address

3822 Schaper Ave
Erie, PA 16508-3360

Phone

(814) 868-0943

Fax

(814) 866-1160

NPI assigned

Mar 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1346200680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3822 SCHAPER AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165083360",
            "telephone_number": "814-864-0943",
            "fax_number": "814-864-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3822 SCHAPER AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165083360",
            "telephone_number": "814-868-0943",
            "fax_number": "814-866-1160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLY",
        "first_name": "DENNIS",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD017266E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000884452",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008844520002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thad Joseph Scott, MA
• Susan Blaisdell Scriven, CRNP
• Alison R Sculley, OT
• Danielle Sculley
• Amanda Scully, DPT
• Lawrence Scully, DMD
• Sharon Scully, CRNP
• Kathleen Ann Scutella, CRNP
• Kimberly Scutella, APN
• Michael A Scutella, MD

• All providers in Erie, PA
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2013; 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.