Individual provider Active NPI

Andrea Catherine Scholl, APN

  • Adult Health Clinical Nurse Specialist
  • Peoria, IL
National Provider Identifier
1598926172
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
209007045041319679 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61603-3133
Phone
(309) 655-2551
NPI assigned
Jun 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 209007045041319679 IL Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61603-3133

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61603-3133
Phone (309) 655-2551

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
209007045041319679ILMDAdult Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1598926172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033133",
            "telephone_number": "309-655-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033133",
            "telephone_number": "309-655-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOLL",
        "first_name": "ANDREA",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IL",
            "license": "209007045041319679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.