Individual provider Active NPI

Kay Bowman Scavulli, RN

  • Registered Nurse
  • San Diego, CA
National Provider Identifier
1639207608
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
215702 Issued in CA
Practice address
2440 Grand Ave
San Diego, CA 92109-4858
Phone
(858) 490-4428
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 215702 CA Primary

Addresses

Primary practice location

2440 Grand Ave
San Diego, CA 92109-4858

Mailing address

7905 Avenida Alamar
La Jolla, CA 92037-3313
Phone (858) 454-5361

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
215702CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639207608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7905 AVENIDA ALAMAR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920373313",
            "telephone_number": "858-454-5361",
            "fax_number": "858-490-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 GRAND AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094858",
            "telephone_number": "858-490-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCAVULLI",
        "first_name": "KAY",
        "middle_name": "BOWMAN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "215702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

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.

Verify at the official NPI Registry.