Fred Orlen Scruggs Jr., PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60627709 Issued in WA

Practice address

9621 Ridgetop Blvd NW
Silverdale, WA 98383-8502

Phone

(360) 782-3300

NPI assigned

Jan 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: fred.scruggs@3856.securemail.prognocis.com

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1245201466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9621 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9621 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838502",
            "telephone_number": "360-782-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Boone Rd",
            "address_purpose": "LOCATION",
            "city": "Bremerton",
            "state": "WA",
            "postal_code": "98312",
            "country_code": "US",
            "telephone_number": "360-475-4379",
            "fax_number": "360-475-4675",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Boone Rd",
            "address_purpose": "LOCATION",
            "city": "Bremerton",
            "state": "WA",
            "postal_code": "98312",
            "country_code": "US",
            "telephone_number": "360-475-4379",
            "fax_number": "360-475-4675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCRUGGS",
        "first_name": "FRED",
        "middle_name": "ORLEN",
        "name_suffix": "Jr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60627709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Schwieterman, SFIDC
• Christina Schwindt, PA-C
• Scott W Stewart DMD PLLC
• Emilie Elsa Scott, CNA
• Kessley Bleu Medina Scott, DO
• SE Clearbrook Opco, LLC
• SE Northwoods Opco, LLC
• Seattle Vamc
• Maria Lynn Selph, LMP
• Lindsey K. Sewell, O.D.

• Physician Assistant in Silverdale, WA
• Providers in Silverdale, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.