Cornelius Jim Scanlon

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

2650 E Show Low Lake Rd
Ste 3
Show Low, AZ 85901-7955

Phone

(928) 537-8196

NPI assigned

Jul 2, 2006

Sex

Male

Sole proprietor

No

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.

• White Mountain Physical Therapy LTD

  • Physical Therapist
  • Show Low, AZ
  • NPI 1750385654
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871522656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 194",
            "city": "PINETOP",
            "state": "AZ",
            "postal_code": "859350194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 E SHOW LOW LAKE RD",
            "address_2": "STE 3",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017955",
            "telephone_number": "928-537-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLON",
        "first_name": "CORNELIUS",
        "middle_name": "JIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaun Sanchez
• Jose Santiago-Cardona
• Ashley Brooke Sarchet, RN
• Michael J Sassmann, PA-C
• Elaine Denise Sawyers, MSW
• Stephanie Schurkens
• Robert D Seaton, M.D.
• Tara Semingson Green, PTA
• Trevor Sexton, N.D.
• Nathan Levi Shaw, PMHNP

• All providers in Show Low, AZ
• Physical Therapist in Arizona

• 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.