Active NPI
Jerald Bucky Schmelzer, DDS
- General Practice Dentistry
- Marion, OH
National Provider Identifier
1861581571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 30-016543
- Practice address
- 520 E Center St
Marion, OH 43302-4260 - Phone
- (740) 387-9020
- Fax
- (740) 387-9020
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30-016543 | OH | Primary |
Addresses
Primary practice location
520 E Center St
Marion, OH 43302-4260
Mailing address
1055 Blois Dr
Marion, OH 43302-6728
Phone (740) 389-3531
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0428979 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30-016543 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1861581571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 BLOIS DR",
"city": "MARION",
"state": "OH",
"postal_code": "433026728",
"telephone_number": "740-389-3531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 E CENTER ST",
"city": "MARION",
"state": "OH",
"postal_code": "433024260",
"telephone_number": "740-387-9020",
"fax_number": "740-387-9020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHMELZER",
"first_name": "JERALD",
"middle_name": "BUCKY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "30-016543",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0428979",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marion, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.