Active NPI
Sam Lucas Scardigli, MS, RD
- Registered Dietitian
- Saint Cloud, MN
National Provider Identifier
1639786742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 1200 6TH Ave N
Saint Cloud, MN 56303-2736 - Phone
- (320) 240-2828
- NPI assigned
- Sep 23, 2020
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
1200 6TH Ave N
Saint Cloud, MN 56303-2736
Mailing address
512 177TH Ave NW
Andover, MN 55304-1539
Phone (763) 568-8899
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Necessary Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
Locations
6385 Old Shady Oak Rd
Ste 250
Eden Prairie, MN 55344
Phone (612) 226-0907
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610323200000",
"number": "1639786742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 177TH AVE NW",
"city": "ANDOVER",
"state": "MN",
"postal_code": "553041539",
"telephone_number": "763-568-8899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 6TH AVE N",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563032736",
"telephone_number": "320-240-2828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCARDIGLI",
"first_name": "SAM",
"middle_name": "LUCAS",
"credential": "MS, RD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-23",
"last_updated": "2021-01-11",
"certification_date": "2021-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.