Individual provider Active NPI

Catherine Scruggs

  • Student in an Organized Health Care Education/Training Program
  • Springfield, MO
National Provider Identifier
1790424620
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
901 S National Ave # Prof160
Springfield, MO 65897-0027
Phone
(417) 836-8553
NPI assigned
May 31, 2022
Last updated
May 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Athletic Trainer 2255A2300X

Addresses

Primary practice location

901 S National Ave # Prof160
Springfield, MO 65897-0027

Mailing address

5036 S Greenbriar Ave
Springfield, MO 65804-7746
Phone (417) 689-0974

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherNONE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Catherine1215@live.missouristate.edu

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

NPI Registry JSON

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1790424620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5036 S GREENBRIAR AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658047746",
            "telephone_number": "417-689-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S NATIONAL AVE # PROF160",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658970027",
            "telephone_number": "417-836-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCRUGGS",
        "first_name": "CATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Catherine1215@live.missouristate.edu",
            "affiliation": "N",
            "address_1": "901 S National Ave # Prof160",
            "city": "Springfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "658970027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.