SPENCER PHILIP SHOLL – Physician Assistant, NPI 1427805258

SPENCER PHILIP SHOLL is a healthcare provider. based in Edwardsville, Illinois. specializing in PHYSICIAN ASSISTANT. They hold a License No. 085011027 (IL). The NPI Number for SPENCER PHILIP SHOLL is 1427805258

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
SPENCER PHILIP SHOLL
NPI
1427805258
Phone
(618) 975-4658
Address
104 Chattanooga Ct
Enumeration Date
30 April 2024
Last Update Date
18 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6186245510
Graduation Year
2024 (2 years ago)
PAC ID
3870022528
Group Practice PAC ID
5092857821
Professional Enrollment ID
I20250124000382
Address ID
IL622691953OF1512XRDXX502

Contacts

Secure Messaging
ssholl469496@ewd.direct.hshs.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Other namesUpdated within 12 months

5,035 PHYSICIAN ASSISTANT in IL

Provider Addresses for SPENCER PHILIP SHOLL

  • 104 Chattanooga Ct

    Edwardsville, IL 620253196

    Phone: (618) 975-4658

    Type: Location

  • 3 SAINT ELIZABETH BLVD STE 5000

    O FALLON, IL 622691282

    Phone: (618) 641-5803

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-01-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250124000382IPhysician AssistantILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62025)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5092857821View full group profile

Reviews

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Frequently asked questions

Can I cross-check SPENCER PHILIP SHOLL using NPI 1427805258?
NPI 1427805258 belongs to SPENCER PHILIP SHOLL; compare other details if you need extra assurance.
Is there an active status for SPENCER PHILIP SHOLL?
For scheduling context, SPENCER PHILIP SHOLL is shown as active in the registry.
What expertise is attributed to SPENCER PHILIP SHOLL?
SPENCER PHILIP SHOLL's specialty line reads Physician Assistant. Clinical services aligned with this taxonomy classification.
Where in Illinois is SPENCER PHILIP SHOLL registered?
Use Edwardsville, Illinois as the headline location for SPENCER PHILIP SHOLL here.
When was this NPI issued?
Enumeration for SPENCER PHILIP SHOLL is noted as April 30, 2024 where the registry provides it.

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