Marvina Scruggs

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Practice address

379 E 47TH St
Jacksonville, FL 32208-5463

Phone

(904) 726-7970

NPI assigned

Oct 30, 2018

Last updated

Dec 27, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1609343474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 E 47TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322085463",
            "telephone_number": "904-726-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 E 47TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322085463",
            "telephone_number": "904-726-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCRUGGS",
        "first_name": "MARVINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "FL",
            "license": "235397",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "81-1835965",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Cecil Scrogins, RPH
• Constanze N Scrone, P.T.
• Sarah Catherine Scruby
• Percy M Scruggins Jr.
• Kniesha Katherine Scruggs
• Christopher B Scuderi, D.O.
• Gaelyn Elizabeth Lee Scuderi, M.D.
• Sophia Forsyth Scully, CAA
• Halima Scurry
• SD Carter Enterprises

• Developmental Disabilities Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; 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.