Active NPI
Derrick Wayne Scoggins, APRN
- Nurse Practitioner
- Bowling Green, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3016140
- Practice address
- 201 Park St
Bowling Green, KY 42101-1708 - Phone
- (270) 783-3362
- Fax
- (270) 780-0472
- NPI assigned
- Jun 21, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3016140 | KY | Primary |
| Family Nurse Practitioner | 363LF0000X | 3016140 | KY |
Addresses
Primary practice location
201 Park St
Bowling Green, KY 42101-1708
Mailing address
201 Park St
Bowling Green, KY 42101-1708
Phone (270) 781-5111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
250 Park St
Bowling Green, KY 42101-1795
Phone (270) 745-1000
Hospital & facility affiliations
- The Medical Center (Bowling Green)
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3016140 | KY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Emergency Physicians LLC | Nurse Practitioner | Current | Accepting new patients |
| Graves Gilbert Clinic PLLC | Nurse Practitioner | Current | Accepting new patients |
| Graves Gilbert Clinic PLLC | Current | Accepting new patients |
Locations
6807 Louisville Rd
Bowling Green, KY 42101
Phone (270) 597-3757
5796 Nashville Rd
Bowling Green, KY 42101
Phone (270) 745-0987
2724 Nashville Rd
Bowling Green, KY 42101
Phone (270) 780-0560
1225 Fairway St
Bowling Green, KY 42103
Phone (270) 781-3910
5575 Scottsville Rd
Bowling Green, KY 42104
Phone (270) 282-7088
201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229
250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000
1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521
1112 S Main St
Franklin, KY 42134
Phone (270) 586-1969
405 S L Rogers Wells Blvd
Glasgow, KY 42141
Phone (270) 479-0260
910 Wallace Ave
Leitchfield, KY 42754
Phone (270) 259-3035
Interoperability endpoints
- derrickscoggins@ggc.allscriptsdirect.net
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Maysville, KY
- NPI 1356379382
Nurse Practitioner
-
- Emergency Medicine Physician
- Leitchfield, KY
- NPI 1649743667
-
- Rural Health Clinic/Center
- Cave City, KY
- NPI 1104635663
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bowling Green, KY
- NPI 1043293608
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699833600000",
"number": "1053980540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 PARK ST",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421011708",
"telephone_number": "270-781-5111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 PARK ST",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421011708",
"telephone_number": "270-783-3362",
"fax_number": "270-780-0472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOGGINS",
"first_name": "DERRICK",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-21",
"last_updated": "2023-11-13",
"certification_date": "2023-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "3016140",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "3016140",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bowling Green, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.