NPIMap

Organization Active NPI

Scott J Arbaugh MD

  • Psychiatry Physician
  • Alton, IL
National Provider Identifier
1104007467
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SCOTT J ARBAUGH MD
Practice address
1 Memorial Dr
Alton, IL 62002-6722
Phone
(636) 695-4554
Fax
(636) 695-3099
NPI assigned
Nov 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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

Authorized official

Name
Dr. Scott J Arbaugh, MDNPI 1861553513
Title
Owner
Phone
(636) 695-4554

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1 Memorial Dr
Alton, IL 62002-6722

Mailing address

1001 Boardwalk Springs PL
Suite 111a
O Fallon, MO 63368-4778
Phone (636) 695-4554

Other identifiers 1

IdentifierTypeStateIssuer
K159153OtherILPROVIDER NUMBER

National Provider Directory

National Provider Directory

Locations

1001 Boardwalk Springs Pl
Ste 111A
O Fallon, MO 63368
Phone (618) 407-9363

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285027200000",
    "number": "1104007467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BOARDWALK SPRINGS PL",
            "address_2": "SUITE 111A",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633684778",
            "telephone_number": "636-695-4554",
            "fax_number": "636-695-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026722",
            "telephone_number": "636-695-4554",
            "fax_number": "636-695-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT J ARBAUGH MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2010-09-21",
        "status": "A",
        "authorized_official_last_name": "ARBAUGH",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-695-4554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "K159153",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.