Cyril Malvin Scully Jr., DPM

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

PD006R Issued in LA

Practice address

3510 Severn Ave
Metairie, LA 70002-3444

Phone

(504) 455-1777

Fax

(504) 455-5361

NPI assigned

Aug 18, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 1971

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1629060389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 SEVERN AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023444",
            "telephone_number": "504-455-1777",
            "fax_number": "504-455-5361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 SEVERN AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023444",
            "telephone_number": "504-455-1777",
            "fax_number": "504-455-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLY",
        "first_name": "CYRIL",
        "middle_name": "MALVIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "LA",
            "license": "PD006R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1397679",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomyjah Kyliah Scott
• Timeka Scott
• Tyrun Scott
• Kamryn Blaire Scroggins
• Arthur Jules Scudari Jr., M.ED., NCC, LPC
• Kolby Sculthorp, DPT
• Jacob McGraw Seale
• Madison Seals
• Christa M Seamon
• Anthony Eugene Seamster, LPC, NCC, LLC

• Foot Surgery Podiatrist in Metairie, LA
• Providers in Metairie, LA by specialty
• Foot Surgery Podiatrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.