Scott Lawrence Teahan, SFIDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

101 Puller Dr
Jacksonville, NC 28540-6228

Phone

(775) 691-6458

NPI assigned

Jul 22, 2011

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

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311292800000",
    "number": "1578841771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PULLER DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285406228",
            "telephone_number": "775-691-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PULLER DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285406228",
            "telephone_number": "775-691-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAHAN",
        "first_name": "SCOTT",
        "middle_name": "LAWRENCE",
        "credential": "SFIDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-22",
        "last_updated": "2011-07-22",
        "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": []
}

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• Independent Duty Corpsman in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Independent Duty Corpsman in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; 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.