Organization Active NPI

Scott Peters DPM CWS LTD

  • Foot & Ankle Surgery Podiatrist
  • Mayfield Village, OH
National Provider Identifier
1427093160
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36003015P Issued in OH
Legal business name
SCOTT PETERS DPM CWS LTD
Practice address
730 Som Center Rd
Mayfield Village, OH 44143-2350
Phone
(440) 995-1111
Fax
(440) 995-1234
NPI assigned
Jun 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Authorized official

Name
Dr. Scott G Peters, DPM, CWSNPI 1427002757
Title
Owner
Phone
(440) 995-1111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 36003015P OH Primary

Addresses

Primary practice location

730 Som Center Rd
Mayfield Village, OH 44143-2350

Mailing address

730 Som Center Rd
Mayfield Village, OH 44143-2362
Phone (440) 995-1111

Other identifiers 2

IdentifierTypeStateIssuer
2663809MedicaidOH
CK2777OtherOHMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040615001372 OH Part B Supplier - Clinic/Group Practice 6103800362 Receives reassigned benefits from 1 practitioner
Practice locations: Mayfield Village, OH
O20100930033600 OH DME Supplier - Physician - Podiatry 6103800362 Practice locations: Mayfield Village, OH

National Provider Directory

National Provider Directory

Locations

29001 Cedar Rd
Ste 550
Lyndhurst, OH 44124
Phone (440) 461-1170

730 Som Center Rd
Ste 350
Mayfield Vlg, OH 44143
Phone (440) 565-1111

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212105600000",
    "number": "1427093160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 SOM CENTER RD",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441432362",
            "telephone_number": "440-995-1111",
            "fax_number": "440-995-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 SOM CENTER RD",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441432350",
            "telephone_number": "440-995-1111",
            "fax_number": "440-995-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT PETERS DPM CWS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-995-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM, CWS"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36003015P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2663809",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CK2777",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield Village, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.