Berks Foot Specialists, PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

SC002902L Issued in PA

Legal business name

BERKS FOOT SPECIALISTS, PC

Practice address

4885 Demoss Rd
Suite 103
Reading, PA 19606-9023

Phone

(610) 779-4020

Fax

(610) 779-7044

NPI assigned

Jun 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bradly Scott Shollenberger, D.P.M.NPI 1366433591

Title

President

Phone

(610) 779-4020

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradly Scott Shollenberger, D.P.M.

  • Podiatrist
  • Reading, PA
  • NPI 1366433591
  Medicare reassignment Care Compare group NPD Authorized official
• David Quinlan, D.P.M.

  • Foot Surgery Podiatrist
  • Reading, PA
  • NPI 1326458308
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1548466261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4885 DEMOSS RD",
            "address_2": "SUITE 103",
            "city": "READING",
            "state": "PA",
            "postal_code": "196069023",
            "telephone_number": "610-779-4020",
            "fax_number": "610-779-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4885 DEMOSS RD",
            "address_2": "SUITE 103",
            "city": "READING",
            "state": "PA",
            "postal_code": "196069023",
            "telephone_number": "610-779-4020",
            "fax_number": "610-779-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKS FOOT SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "SHOLLENBERGER",
        "authorized_official_first_name": "BRADLY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-779-4020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC002902L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011820330007",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "31854",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "688055",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "000688055",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHP CENTRAL",
            "identifier": "01328801",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "02363800",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHP EAST",
            "identifier": "0522660000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Reading, PA
• Providers in Reading, PA by specialty
• Foot & Ankle Surgery Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.