Individual provider Active NPI

Scott Allan Draper, D.D.S., M.S.

  • Prosthodontics
  • Colorado Springs, CO
National Provider Identifier
1124111406
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
8698 Issued in CO
Practice address
1155 Kelly Johnson Blvd
Suite 210
Colorado Springs, CO 80920-3932
Phone
(719) 532-1007
Fax
(719) 532-0048
NPI assigned
Oct 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 8698 CO Primary

Addresses

Primary practice location

1155 Kelly Johnson Blvd
Suite 210
Colorado Springs, CO 80920-3932

Mailing address

3527 Oak Meadow Dr
Colorado Springs, CO 80920-2404
Phone (719) 264-0563

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8698COMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Colleen Jenson, LLC PastSince Aug 18, 2019 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124111406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3527 OAK MEADOW DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809202404",
            "telephone_number": "719-264-0563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 KELLY JOHNSON BLVD",
            "address_2": "SUITE 210",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203932",
            "telephone_number": "719-532-1007",
            "fax_number": "719-532-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAPER",
        "first_name": "SCOTT",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CO",
            "license": "8698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.