Scott O Caudle

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN12619 Issued in TN

Legal business name

SCOTT O CAUDLE

Practice address

1503 W Elk Ave Ste 3
Elizabethton, TN 37643-2883

Phone

(423) 543-6660

Fax

(423) 543-5133

NPI assigned

Jul 6, 2007

Reactivated

Aug 16, 2007

Organization subpart

No

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

Authorized official

Name

Scott Okrina Caudle, MDNPI 1770570772

Title

Owner Doctor

Phone

(423) 543-8619

Specialties & licenses 1

Addresses

Other names 1

• Mountain Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott O Caudle, MD

  • General Practice Physician
  • Elizabethton, TN
  • NPI 1770570772

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Caitlin Nichole Powers, APRN

  • Family Nurse Practitioner
  • Knoxville, TN
  • NPI 1639680770
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1396943841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 W ELK AVE STE 3",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432883",
            "telephone_number": "423-543-6660",
            "fax_number": "423-543-5133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 W ELK AVE STE 3",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432883",
            "telephone_number": "423-543-6660",
            "fax_number": "423-543-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT O CAUDLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-06",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "deactivation_date": "2007-08-01",
        "reactivation_date": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "CAUDLE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "OKRINA",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "423-543-8619",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN12619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David S Saunders, MD
• Natalie Scanlon, M.A., SLP-CCC
• Craig D Schmalzried, M.D.
• Crystal Renee Schmidt, FNP-BC
• Lakeisha Schuettler, RN
• Cassidy Frances Sellner, COTA
• Sandra Lynn Shell, RDH
• Lincoln Shelton, LPC,MHSP
• Karissa Ann Shepard, RN
• Amber L Shepherd, LPN

• Nurse Practitioner in Elizabethton, TN
• Providers in Elizabethton, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.