Active NPI
Edgar Rogers Scudder, LCSW
- Clinical Social Worker
- Herkimer, NY
National Provider Identifier
1598897381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R027089-1
- Practice address
- 301 N Washington St Ste 2470
Herkimer, NY 13350-1299 - Phone
- (315) 867-1465
- Fax
- (315) 867-1469
- NPI assigned
- Mar 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R027089-1 | NY | Primary |
Addresses
Primary practice location
301 N Washington St Ste 2470
Herkimer, NY 13350-1299
Mailing address
301 N Washington St Ste 2470
Herkimer, NY 13350-1299
Phone (315) 867-1465
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R027098-1 | Other | NY | NYS LICENSE NUMBER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R027089-1 | NY | MD | Clinical Social Worker |
| 027098 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598897381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 N WASHINGTON ST STE 2470",
"city": "HERKIMER",
"state": "NY",
"postal_code": "133501299",
"telephone_number": "315-867-1465",
"fax_number": "315-867-1469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 N WASHINGTON ST STE 2470",
"city": "HERKIMER",
"state": "NY",
"postal_code": "133501299",
"telephone_number": "315-867-1465",
"fax_number": "315-867-1469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCUDDER",
"first_name": "EDGAR",
"middle_name": "ROGERS",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R027089-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS LICENSE NUMBER",
"identifier": "R027098-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Herkimer, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.