Scholls Pediatric Clinic LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

3542358 Issued in OR

Legal business name

SCHOLLS PEDIATRIC CLINIC LLC

Practice address

12442 SW Scholls Ferry Rd
#205
Tigard, OR 97223-3396

Phone

(503) 579-3214

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Richard Deklotz

Title

Owner

Phone

(503) 579-3214

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188000000000",
    "number": "1689727265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12442 SW SCHOLLS FERRY RD",
            "address_2": "#205",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972233396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12442 SW SCHOLLS FERRY RD",
            "address_2": "#205",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972233396",
            "telephone_number": "503-579-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHOLLS PEDIATRIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-08-25",
        "status": "A",
        "authorized_official_last_name": "DEKLOTZ",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-579-3214"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OR",
            "license": "3542358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Alexandra Schmidt, RN
• Tomas Florian Schmidt, HIS
• Shelley Diane Schmitz
• Gretchen Anna Schneider, RN
• Sara Schnitzler, M.A
• Josephine Schramm
• Harmony Schreiter, BA, QMHA, CADCI
• Carol Lynn Schriner, MD
• Cedra Renee Schrock
• Stephen M Schroeder, DPM

• Medical Specialty Clinic/Center in Tigard, OR
• Providers in Tigard, OR by specialty
• Medical Specialty Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2007; 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.