Provider Demographics
NPI:1255423075
Name:HARNDEN, SCOTT GREGORY (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:GREGORY
Last Name:HARNDEN
Suffix:
Gender:M
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:10801 E STATE ROUTE 350 STE B
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64138-2384
Practice Address - Country:US
Practice Address - Phone:816-737-5500
Practice Address - Fax:816-737-5504
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006025819225XH1200X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKS2868052OtherMEDICARE PTAN
MOMA4370013OtherMEDICARE PTAN
37457141OtherBCBS KC
MO37457131OtherBCBS KC
MO37457121OtherBCBS KC
MOMA2104007Medicare PIN
MOMA1009008Medicare PIN
MOX60E777Medicare PIN