Individual provider Active NPI

Charlotte Scott, PA

  • Physician Assistant
  • Fort Hood, TX
National Provider Identifier
1063475309
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01636 Issued in TX
Practice address
BLDG 2245, 58TH Street and 761St Tank Battalion Avenue
Fort Hood, TX 76544-0000
Phone
(254) 287-5029
NPI assigned
Apr 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01636 TX Primary

Addresses

Primary practice location

BLDG 2245, 58TH Street and 761St Tank Battalion Avenue
Fort Hood, TX 76544-0000

Mailing address

4204 E Stan Schlueter Loop
Killeen, TX 76542-8352
Phone (254) 690-2800

Other identifiers 2

IdentifierTypeStateIssuer
P00269379OtherTXRR/MEDICARE
8N9121OtherTXBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615000905 TX Practitioner - Physician Assistant 7315921624 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA01636TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
LHP Texas MD Services, Inc CurrentSince Jul 1, 2018 Accepting new patients
Round Rock Mental Health PA Past Accepting new patients
Central Texas Pain Center, PLLC Past Accepting new patients
Central Texas Pain Institute PLLC PastSince Nov 12, 2012 Accepting new patients

Locations

800 W Central Texas Expy
Harker Heights, TX 76548
Phone (254) 618-4933

100 W Central Texas Expy
Ste 210
Killeen, TX 76548

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.

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1063475309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 E STAN SCHLUETER LOOP",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765428352",
            "telephone_number": "254-690-2800",
            "fax_number": "254-690-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 2245, 58TH STREET AND 761ST TANK BATTALION AVENUE",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765440000",
            "telephone_number": "254-287-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "CHARLOTTE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-08",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR/MEDICARE",
            "identifier": "P00269379",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "8N9121",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Hood, TX

Sources for this page

Verify at the official NPI Registry.