Individual provider Active NPI

Scott R Tuttle

  • Case Manager/Care Coordinator
  • Diamond Springs, CA
National Provider Identifier
1366607061
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
768 Pleasant Valley Rd Ste 201
Diamond Springs, CA 95619-9260
Phone
(530) 621-6290
Fax
(530) 622-1293
NPI assigned
Jul 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 7154 CA
Case Manager/Care Coordinator 171M00000X Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

768 Pleasant Valley Rd Ste 201
Diamond Springs, CA 95619-9260

Mailing address

768 Pleasant Valley Rd Ste 201
Diamond Springs, CA 95619-9260
Phone (530) 621-6290

Other practice location 1

2914 Cold Springs Rd
Ste A
Placerville, CA 95667-4220
Phone (530) 642-1715

Other identifiers 1

IdentifierTypeStateIssuer
7154OtherCACAS

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

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1366607061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "768 PLEASANT VALLEY RD STE 201",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199260",
            "telephone_number": "530-621-6290",
            "fax_number": "530-622-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "768 PLEASANT VALLEY RD STE 201",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199260",
            "telephone_number": "530-621-6290",
            "fax_number": "530-622-1293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2914 Cold Springs Rd",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Placerville",
            "state": "CA",
            "postal_code": "956674220",
            "country_code": "US",
            "telephone_number": "530-642-1715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUTTLE",
        "first_name": "SCOTT",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-22",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "7154",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAS",
            "identifier": "7154",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.