Individual provider Active NPI

Scott David Arnold

  • Independent Duty Corpsman
  • Great Lakes, IL
National Provider Identifier
1497917876
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
320 Dewey Ave Ste a
Naval Special Warfare Preparatory School BLDG 322
Great Lakes, IL 60088-2911
Phone
(847) 688-6201
Fax
(847) 688-6140
NPI assigned
Jun 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Primary

Addresses

Primary practice location

320 Dewey Ave Ste a
Naval Special Warfare Preparatory School BLDG 322
Great Lakes, IL 60088-2911

Mailing address

320 Dewey Ave Ste a
Naval Special Warfare Preparatory School BLDG 322
Great Lakes, IL 60088-2911
Phone (847) 688-6201

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1497917876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 DEWEY AVE STE A",
            "address_2": "NAVAL SPECIAL WARFARE PREPARATORY SCHOOL BLDG 322",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600882911",
            "telephone_number": "847-688-6201",
            "fax_number": "847-688-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 DEWEY AVE STE A",
            "address_2": "NAVAL SPECIAL WARFARE PREPARATORY SCHOOL BLDG 322",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600882911",
            "telephone_number": "847-688-6201",
            "fax_number": "847-688-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "SCOTT",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Lakes, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; 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.