Individual provider Active NPI

Scott Alan Caldwell, A.T.C.,LAT

  • Athletic Trainer
  • Little Rock, AR
National Provider Identifier
1184901894
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT 282 Issued in AR
Practice address
8907 Kanis Rd
Suite Number 300
Little Rock, AR 72205-6449
Phone
(501) 227-9994
NPI assigned
Nov 9, 2011
Last updated
Nov 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT 282 AR Primary

Addresses

Primary practice location

8907 Kanis Rd
Suite Number 300
Little Rock, AR 72205-6449

Mailing address

5 Kelli CT
Mabelvale, AR 72103-2219
Phone (501) 351-1171

Other identifiers 1

IdentifierTypeStateIssuer
22OtherAR22 RESPIRATORY, REHABILATATIVE AND RESTORATIVE PROVIDER

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

LicenseStateTypeSpecialty
AT 282ARMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1184901894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 KELLI CT",
            "city": "MABELVALE",
            "state": "AR",
            "postal_code": "721032219",
            "telephone_number": "501-351-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8907 KANIS RD",
            "address_2": "SUITE NUMBER 300",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056449",
            "telephone_number": "501-227-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "SCOTT",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "A.T.C.,LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-09",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AR",
            "license": "AT 282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "22 RESPIRATORY, REHABILATATIVE AND RESTORATIVE PROVIDER",
            "identifier": "22",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.