NPIMap

Organization Active NPI

Scott J.M. Lim, D.O. LLC

  • Dermatology Physician
  • Erie, PA
National Provider Identifier
1063486876
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
OS006153L Issued in PA
Legal business name
SCOTT J.M. LIM, D.O. LLC
Practice address
3243 W 26TH St
Erie, PA 16506-2507
Phone
(814) 836-1300
Fax
(814) 836-1346
NPI assigned
Feb 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Scott Jit-Meng Lim, D.O.NPI 1376517151
Title
Owner/Manager
Phone
(814) 836-1300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X OS006153L PA Primary

Addresses

Primary practice location

3243 W 26TH St
Erie, PA 16506-2507

Mailing address

3243 W 26TH St
Erie, PA 16506-2507
Phone (814) 836-1300

Other identifiers 4

IdentifierTypeStateIssuer
1500347OtherPAGATEWAY MA PROV ID
412984OtherPAHIGHMARK BLUE SHIELD ID
07003058OtherPARAILROAD MEDICARE PROV ID
1011067500001MedicaidPA

National Provider Directory

National Provider Directory

Locations

3243 W 26th St
Erie, PA 16506
Phone (814) 836-1300

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063486876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3243 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165062507",
            "telephone_number": "814-836-1300",
            "fax_number": "814-836-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3243 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165062507",
            "telephone_number": "814-836-1300",
            "fax_number": "814-836-1346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT J.M. LIM, D.O. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "JIT-MENG",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "814-836-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "PA",
            "license": "OS006153L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY MA PROV ID",
            "identifier": "1500347",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD ID",
            "identifier": "412984",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROV ID",
            "identifier": "07003058",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011067500001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.