Individual provider Active NPI

Terry J Scofield, P.A.

  • Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1356449094
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
979 Issued in CO
Practice address
1107 S Lemay Ave
Suite 200
Fort Collins, CO 80524-3960
Phone
(970) 484-1757
Fax
(970) 484-9924
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 979 CO Primary

Addresses

Primary practice location

1107 S Lemay Ave
Suite 200
Fort Collins, CO 80524-3960

Mailing address

3702 Automation Way
Suite 103
Fort Collins, CO 80525-5737
Phone (970) 224-1670

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0000979COMDSpeech-Language Pathologist
979COMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1356449094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 AUTOMATION WAY",
            "address_2": "SUITE 103",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255737",
            "telephone_number": "970-224-1670",
            "fax_number": "970-495-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 S LEMAY AVE",
            "address_2": "SUITE 200",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243960",
            "telephone_number": "970-484-1757",
            "fax_number": "970-484-9924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOFIELD",
        "first_name": "TERRY",
        "middle_name": "J",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.

Verify at the official NPI Registry.