Individual provider Active NPI

Olivia Elyse Scholes

  • Pediatrics Physician
  • Marshfield, WI
National Provider Identifier
1720824113
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
101092851 Issued in WI
Practice address
611 N Saint Joseph Ave
Marshfield, WI 54449-1832
Phone
(866) 520-2510
NPI assigned
Jul 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 101092851 WI Primary

Addresses

Primary practice location

611 N Saint Joseph Ave
Marshfield, WI 54449-1832

Mailing address

404 W Mill St
Spencer, WI 54479-9797
Phone (435) 213-6317

Other names 1

  • Olivia Elyse Craig Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251103001092 WI Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4981193547

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101092851WIMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1720824113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 W MILL ST",
            "city": "SPENCER",
            "state": "WI",
            "postal_code": "544799797",
            "telephone_number": "435-213-6317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N SAINT JOSEPH AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544491832",
            "telephone_number": "866-520-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOLES",
        "first_name": "OLIVIA",
        "middle_name": "ELYSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "101092851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVIA",
            "last_name": "CRAIG",
            "middle_name": "ELYSE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marshfield, WI

Sources for this page

Verify at the official NPI Registry.