Organization Active NPI

Scrodco PLLC

  • Podiatrist
  • St George, UT
National Provider Identifier
1306368402
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
SCRODCO PLLC
Doing business as
Southwest Foot & Ankle
Practice address
676 S Bluff St Ste 205
St George, UT 84770-3568
Phone
(435) 628-5690
Fax
(435) 628-5805
NPI assigned
Jul 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Authorized official

Name
Dr. David Magnesen, DPMNPI 1699779066
Title
Proprietor
Phone
(435) 628-5690

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

676 S Bluff St Ste 205
St George, UT 84770-3568

Mailing address

676 S Bluff St Ste 205
St George, UT 84770-3568
Phone (435) 628-5690

Other names 1

  • Southwest Foot & Ankle Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100930017214 UT DME Supplier - Physician - PodiatryDME Supplier - Orthotic Personnel 9436270576 1 other NPI on this enrollment
Practice locations: St George, UT
O20170919003266 UT Part B Supplier - Clinic/Group Practice 9436270576 Receives reassigned benefits from 2 practitioners
Practice locations: St George, UT
O20190718003144 NV Part B Supplier - Clinic/Group Practice 9436270576 Receives reassigned benefits from 1 practitioner
Practice locations: Caliente, NV

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Southwest Foot & Ankle676 S Bluff St, St George, UT 84770-3568(435) 628-5690 Negative Pressure Wound Therapy Pumps/Supplies|Canes and/or Crutches|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Surgical Dressings|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Oct 30, 2010

National Provider Directory

National Provider Directory

Locations

1745 E 280 N
St George, UT 84790
Phone (435) 628-5701

676 S Bluff St
Ste 205
St George, UT 84770
Phone (435) 628-5690

Practitioners & affiliated clinicians

Practitioners 2

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": "1499644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1306368402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 S BLUFF ST STE 205",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703568",
            "telephone_number": "435-628-5690",
            "fax_number": "435-628-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 S BLUFF ST STE 205",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703568",
            "telephone_number": "435-628-5690",
            "fax_number": "435-628-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCRODCO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-10",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "MAGNESEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "435-628-5690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Foot & Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.