Mitchell Scoggins

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

060479359 Issued in IL

Practice address

601 Industrial Park Rd
Monmouth, IL 61462-9796

Phone

(309) 734-8428

NPI assigned

Aug 5, 2016

Last updated

Aug 5, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• City of Monmouth

  • Land Ambulance
  • Monmouth, IL
  • NPI 1134270812
  NPD (past)

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1528512720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 INDUSTRIAL PARK RD",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614629796",
            "telephone_number": "309-734-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 INDUSTRIAL PARK RD",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614629796",
            "telephone_number": "309-734-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOGGINS",
        "first_name": "MITCHELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-05",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "IL",
            "license": "060479359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Raymond, LPC
• Casey Rexroat
• Kathryn Elizabeth Ringberg
• Adam Edward Sanberg, D.M.D.
• Natalee Schweppe, PHARMD
• Philip Gene Sexton, D.D.S.
• Steven Shearer, R. PH
• Leah Shimmin, APNCNP
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 145)
• Shopko Stores Operating Co. LLC (ShopKo Optical 145)

• Basic Emergency Medical Technician in Monmouth, IL
• Providers in Monmouth, IL by specialty
• Basic Emergency Medical Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2016; 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.