Individual provider Active NPI

John Sargent Sholl, MD

  • Maternal & Fetal Medicine Physician
  • Lac Du Flambeau, WI
National Provider Identifier
1417982448
Registry record updated Aug 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
51208-20 Issued in WI
Practice address
2133 To to Tom Dr
Lac Du Flambeau, WI 54538-9661
Phone
(715) 928-2650
NPI assigned
Jul 11, 2006
Last updated
Aug 13, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 51208-20 WI Primary

Addresses

Primary practice location

2133 To to Tom Dr
Lac Du Flambeau, WI 54538-9661

Mailing address

2133 To to Tom Dr
Lac Du Flambeau, WI 54538-9661
Phone (715) 928-2650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51208-20WIMDMaternal & Fetal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281657600000",
    "number": "1417982448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2133 TO TO TOM DR",
            "city": "LAC DU FLAMBEAU",
            "state": "WI",
            "postal_code": "545389661",
            "telephone_number": "715-928-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 TO TO TOM DR",
            "city": "LAC DU FLAMBEAU",
            "state": "WI",
            "postal_code": "545389661",
            "telephone_number": "715-928-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOLL",
        "first_name": "JOHN",
        "middle_name": "SARGENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2010-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "WI",
            "license": "51208-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lac Du Flambeau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; 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.