MEDICARE: SCHOLL SPINE AND SPORT, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	1839	NE

General Provider Information

NPI Number	:	1750802203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHOLL SPINE AND SPORT, P.C.

Provider Business Mailing Address
First Line	:	16811 M CIR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68135-1457
Country	:	US
Telephone Number	:	402-843-8830
Fax Number	:	531-999-3664

Provider Business Practice Location Address
First Line	:	16811 M CIR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68135-1457
Country	:	US
Telephone Number	:	402-843-8830
Fax Number	:	531-999-3664

Authorized Official
Title or Position	:	OWNER & PRESIDENT
Name	:	DEREK ALAN SCHOLL
Credential	:	D.C.
Telephone Number	:	402-843-8830

Provider Enumeration Date	:	07/05/2017
Last Update Date	:	01/20/2026

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