Active NPI
John A Scandurra
- Veterinarian
- Saint Paul, MN
National Provider Identifier
1194134981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Veterinarian
- License
- 02510
- Practice address
- 438 Portland Ave
Apt 8
Saint Paul, MN 55102-2290 - Phone
- (612) 819-0168
- NPI assigned
- Aug 6, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 02510 | MN | Primary |
Addresses
Primary practice location
438 Portland Ave
Apt 8
Saint Paul, MN 55102-2290
Mailing address
438 Portland Avenue
Apt 8
Saint Paul, MN 55102
Phone (612) 819-0168
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
| License | State | Type | Specialty |
|---|---|---|---|
| 02510 | MN | MD | Veterinarian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407283200000",
"number": "1194134981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "438 PORTLAND AVENUE",
"address_2": "APT 8",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "55102",
"telephone_number": "612-819-0168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "438 PORTLAND AVE",
"address_2": "APT 8",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551022290",
"telephone_number": "612-819-0168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCANDURRA",
"first_name": "JOHN",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-06",
"last_updated": "2014-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "174M00000X",
"taxonomy_group": "",
"desc": "Veterinarian",
"state": "MN",
"license": "02510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.