Theodore David Scott, RN, MSN, FNP-C, DCNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP9406 Issued in CA

Practice address

400 Craven Road
Department of Dermatology
San Marcos, CA 92078-4201

Phone

(760) 510-4056

Fax

(760) 510-4212

NPI assigned

Jun 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1871599548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CRAVEN ROAD",
            "address_2": "DEPARTMENT OF DERMATOLOGY",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920794201",
            "telephone_number": "760-510-4056",
            "fax_number": "760-510-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CRAVEN ROAD",
            "address_2": "DEPARTMENT OF DERMATOLOGY",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784201",
            "telephone_number": "760-510-4056",
            "fax_number": "760-510-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "THEODORE",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "RN, MSN, FNP-C, DCNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "RN 495518",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP 9406",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP9406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey Jae Schwier, PHARMD
• Auti Kamal Scolman
• Scott Welling DDS Inc
• Michelle M Scott, DMD
• Patrick Wyatt Scott, PT
• Isabelle Seale
• Maria Sebiane, MD
• Angela Segal
• Heather Seierstad, NP
• Elizabeth Brianna Seighman

• Nurse Practitioner in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.