Kelly L Scoggins, FNP

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

124662 Issued in AZ

Practice address

5310 W Thunderbird Rd
Suite 110
Glendale, AZ 85306-4706

Phone

(602) 865-4065

NPI assigned

Nov 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Banner Physician Super Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1841573870
  Medicare reassignment NPD
• Banner Physician Super Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Mesa, AZ
  • NPI 1386462810
  NPD
• Covenant Medical Group

  • Rural Health Clinic/Center
  • Abernathy, TX
  • NPI 1538412895
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1427137157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD",
            "address_2": "SUITE 110",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064706",
            "telephone_number": "602-865-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD",
            "address_2": "SUITE 110",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064706",
            "telephone_number": "602-865-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOGGINS",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "AZ",
            "license": "RN124662",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "124662",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "124662",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "826737",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Renee Schwagerman, RN
• Edward Schwartz, M.D.
• Joshua David Schwirian, RBT
• Anjali Scites
• Jack V Scodius, DPT
• Paula Kay Scoggins, FNP-C, MSN
• Samantha Anne Score, D.O.
• Scott Group 010 LLC
• Scott M Gulinson MD PC
• Andrea J Scott

• Surgery Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.