Individual provider Active NPI

Beverly Scholler, MD

  • Pediatrics Physician
  • Perrysburg, OH
National Provider Identifier
1780686675
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35056704 Issued in OH
Practice address
25950 Dixie Hwy Ste 400
Perrysburg, OH 43551-2983
Phone
(567) 585-0010
Fax
(567) 225-3490
NPI assigned
Aug 11, 2005
Last updated
Feb 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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 35056704 OH Primary

Addresses

Primary practice location

25950 Dixie Hwy Ste 400
Perrysburg, OH 43551-2983

Mailing address

25950 Dixie Hwy Ste 400
Perrysburg, OH 43551-2983
Phone (567) 585-0010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20080703000436 OH Practitioner - Pediatric Medicine 3173695392 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35056704OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Jan 1, 2020 Accepting new patients
Promedica Central Physicians CurrentSince Jan 1, 2020 Accepting new patients

Locations

660 Beaver Creek Cir
Ste 100
Maumee, OH 43537
Phone (419) 891-6221

25950 Dixie Hwy
Perrysburg, OH 43551
Phone (567) 585-0010

25950 Dixie Hwy
Ste 400
Perrysburg, OH 43551
Phone (567) 585-0010

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1780686675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25950 DIXIE HWY STE 400",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435512983",
            "telephone_number": "567-585-0010",
            "fax_number": "567-225-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25950 DIXIE HWY STE 400",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435512983",
            "telephone_number": "567-585-0010",
            "fax_number": "567-225-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOLLER",
        "first_name": "BEVERLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35056704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.