Active NPI
Deborah A. Scattarelli, CNP
- Adult Health Nurse Practitioner
- Saint Cloud, MN
National Provider Identifier
1427001130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- R-093656-9
- Practice address
- 1586 County Road 134
St. Cloud Hospital
St. Cloud, MN 56303 - Phone
- (320) 251-0726
- Fax
- (320) 229-5188
- NPI assigned
- May 17, 2006
- Last updated
- Aug 6, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | R0936569 | MN | |
| Adult Health Nurse Practitioner | 363LA2200X | R-093656-9 | MN | Primary |
Addresses
Primary practice location
1586 County Road 134
St. Cloud Hospital
St. Cloud, MN 56303
Mailing address
1406 6TH Ave N
St. Cloud Hospital
St. Cloud, MN 56303-1901
Phone (320) 251-2700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 344024900 | Medicaid | MN |
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
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-093656-9 | MN | MD | Adult Health Nurse Practitioner |
| R0936569 | MN | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regional Diagnostic Radiology | Current | Accepting new patients | |
| St. Cloud Hospital | Current | Accepting new patients | |
| Pulmonary & Critical Care Associates, P.a. | Past | Accepting new patients |
Locations
1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657
110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375
Organizations & group practices 3
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.
-
- Diagnostic Radiology Physician
- Sartell, MN
- NPI 1417935321
-
dba St. Paul Lung Clinic
- Multi-Specialty Clinic/Center
- Saint Paul, MN
- NPI 1376595033
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344211200000",
"number": "1427001130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1406 6TH AVE N",
"address_2": "ST. CLOUD HOSPITAL",
"city": "ST. CLOUD",
"state": "MN",
"postal_code": "563031901",
"telephone_number": "320-251-2700",
"fax_number": "320-656-7009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1586 COUNTY ROAD 134",
"address_2": "ST. CLOUD HOSPITAL",
"city": "ST. CLOUD",
"state": "MN",
"postal_code": "56303",
"telephone_number": "320-251-0726",
"fax_number": "320-229-5188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCATTARELLI",
"first_name": "DEBORAH",
"middle_name": "A.",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-17",
"last_updated": "2012-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MN",
"license": "R0936569",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MN",
"license": "R-093656-9",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "344024900",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.