Robert R Sholl, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

008890 Issued in ME

Practice address

4 Wellspring Rd
Biddeford, ME 04005-9401

Phone

(207) 282-3369

Fax

(207) 282-9920

NPI assigned

Oct 11, 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 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 11, 2016 through May 11, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Wellspring Family Medical Associates, PA

  • Family Medicine Physician
  • Biddeford, ME
  • NPI 1235208513
  NPD (past) Authorized official

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1457449423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WELLSPRING RD",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059401",
            "telephone_number": "207-282-3369",
            "fax_number": "207-282-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WELLSPRING RD",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059401",
            "telephone_number": "207-282-3369",
            "fax_number": "207-282-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOLL",
        "first_name": "ROBERT",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "008890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1041129",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1970311",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "320250099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "B86999",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "027353",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Sheldon, P.T.
• Nicholas David Shellenberger, LCSW
• Miranda Leigh Shepherd-Bussiere, LCSW
• Howard B Sherman, M.D.
• Noreen M Sholl, MD
• Crisoula Sicoli
• Amber L Silva, LCSW
• Anna McElroy Simons, DO
• Glenn John Simpson
• Anne M Sirois, LCSW

• Family Medicine Physician in Biddeford, ME
• Providers in Biddeford, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.