Individual provider Active NPI

Scott Willard Sautter, PH.D.

  • Clinical Neuropsychologist
  • Virginia Beach, VA
National Provider Identifier
1679520092
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
0810001696 Issued in VA
Practice address
1604 Hilltop West Ctr Ste 216
Virginia Beach, VA 23451-6131
Phone
(757) 498-9585
Fax
(757) 468-1685
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X
Clinical Neuropsychologist 103G00000X 810001696 VA
Clinical Neuropsychologist 103G00000X 0810001696 VA Primary

Addresses

Primary practice location

1604 Hilltop West Ctr Ste 216
Virginia Beach, VA 23451-6131

Mailing address

1604 Hilltop West Executive Center
216
Virginia Beach, VA 23451
Phone (757) 498-9585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120404000295 VA Practitioner - Clinical Psychologist 4688834302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
810001696VAMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1679520092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 HILLTOP WEST EXECUTIVE CENTER",
            "address_2": "216",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23451",
            "telephone_number": "757-498-9585",
            "fax_number": "757-468-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 HILLTOP WEST CTR STE 216",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234516131",
            "telephone_number": "757-498-9585",
            "fax_number": "757-468-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUTTER",
        "first_name": "SCOTT",
        "middle_name": "WILLARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "810001696",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810001696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.