Individual provider Active NPI

Christopher Louis Scodeller, MD

  • Emergency Medicine Physician
  • Edmonds, WA
National Provider Identifier
1417305137
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD61024219 Issued in WA
Practice address
21601 76TH Ave W
Edmonds, WA 98026-7507
Phone
(425) 640-4000
NPI assigned
Jun 3, 2016
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 125-069414 IL
Emergency Medicine Physician 207P00000X 036149436 IL
Emergency Medicine Physician 207P00000X MD61024219 WA Primary

Addresses

Primary practice location

21601 76TH Ave W
Edmonds, WA 98026-7507

Mailing address

21601 76TH Ave W
Edmonds, WA 98026-7507
Phone (425) 640-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20200831002406 WA Practitioner - Emergency Medicine 9436438371 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Washington School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians
Ballard Emergency Physicians PSGroup PAC ID 1052209368, 24 clinicians

Practice addresses (Care Compare)

21601 76TH Ave W
Edmonds, WA 98026-7507
Phone (425) 640-4100

5300 Tallman Ave NW
Seattle, WA 98107-3932
Phone (206) 782-2700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61024219WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Sep 1, 2020 Accepting new patients
Swedish Health Services CurrentSince Feb 15, 2021 Accepting new patients
Ballard Emergency Physicians, P.S. Emergency Medicine CurrentSince Jun 6, 2022 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Sep 1, 2020 Accepting new patients
Swedish Health Services CurrentSince Feb 15, 2021 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

21600 Highway 99
Ste 240
Edmonds, WA 98026
Phone (206) 774-2632

21601 76th Ave W
Edmonds, WA 98026
Phone (425) 640-4000

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

5300 Tallman Ave NW
Seattle, WA 98107
Phone (206) 781-6209

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 2

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": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1417305137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21601 76TH AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267507",
            "telephone_number": "425-640-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21601 76TH AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267507",
            "telephone_number": "425-640-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCODELLER",
        "first_name": "CHRISTOPHER",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-03",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125-069414",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036149436",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD61024219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.