Individual provider Active NPI

Scott E Lawrance, MS PT

  • Athletic Trainer
  • Indianapolis, IN
National Provider Identifier
1417954637
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
36000633A Issued in IN
Practice address
1400 E Hanna Ave
Indianapolis, IN 46227-3630
Phone
(317) 788-3248
NPI assigned
Jul 1, 2005
Last updated
Sep 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05008318A IN
Athletic Trainer 2255A2300X 36000633A IN Primary

Addresses

Primary practice location

1400 E Hanna Ave
Indianapolis, IN 46227-3630

Mailing address

1400 E Hanna Ave
Indianapolis, IN 46227-3630
Phone (317) 788-3248

Other identifiers 2

IdentifierTypeStateIssuer
DB9030OtherGARAILROAD MEDICARE GROUP NUMBER
P00479057OtherGARAILROAD MEDICARE PTAN

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
Master of Science

State licenses

LicenseStateTypeSpecialty
05008318AINMDPhysical Therapist
36000633AINMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
K Donald Shelbourne MD LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1417954637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E HANNA AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462273630",
            "telephone_number": "317-788-3248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E HANNA AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462273630",
            "telephone_number": "317-788-3248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRANCE",
        "first_name": "SCOTT",
        "middle_name": "E",
        "credential": "MS PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05008318A",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36000633A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP NUMBER",
            "identifier": "DB9030",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00479057",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.