Individual provider Active NPI

Scott Leslie Dennis, PA

  • Physician Assistant
  • Bolivar, MO
National Provider Identifier
1073916573
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2014027674 Issued in MO
Practice address
1500 North Oakland Ave
Citizens Memorial Hospital
Bolivar, MO 65613
Phone
(417) 326-6000
NPI assigned
Sep 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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 2014027674 MO Primary

Addresses

Primary practice location

1500 North Oakland Ave
Citizens Memorial Hospital
Bolivar, MO 65613

Mailing address

1500 North Oakland Ave
Citizens Memorial Hospital
Bolivar, MO 65613
Phone (417) 326-6000

Other practice location 1

525 Branson Landing Blvd
Branson, MO 65616-2052
Phone (417) 335-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20141021003062 MO Practitioner - Physician Assistant 5395966063 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizens Memorial HealthcareGroup PAC ID 4183528169, 144 clinicians

Practice addresses (Care Compare)

Bolivar, MO 65613
Phone (417) 328-6631

1125 N Butterfield Rd
CMH Dermatology
Bolivar, MO 65613-1056
Phone (417) 328-4500

1155 W Parkview
Bolivar, MO 65613-7800

1155 W Parkview
2K CMH Rheumatology
Bolivar, MO 65613-8598
Phone (417) 328-7000

1155 W Parkview St
Bolivar, MO 65613-7800

1155 W Parkview St
Bolivar, MO 65613-8597

1155 W Parkview St
1C
Bolivar, MO 65613-8279
Phone (417) 326-7246

1155 W Parkview St
Suite 2J
Bolivar, MO 65613-8598
Phone (417) 328-7702

1160 W Parkview St
CMH Nephrology Clinic
Bolivar, MO 65613-8279
Phone (417) 328-7300

1245 N Butterfield Rd
Bolivar, MO 65613-3017

1500 N Oakland Ave
CMH Diabetes
Bolivar, MO 65613-3099
Phone (417) 328-6040

1501 N Oakland Ave
CMH Oncology Clinic
Bolivar, MO 65613-3020
Phone (417) 328-7200

2001 W Broadway St
Bolivar, MO 65613-1861

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Springfield CurrentSince Apr 1, 2025 Accepting new patients
Skaggs Community Hospital Association CurrentSince Apr 21, 2025 Accepting new patients
Citizens Memorial Healthcare CurrentSince Sep 22, 2014 Accepting new patients
Citizens Memorial Healthcare Physician Assistant CurrentSince Sep 22, 2014 Accepting new patients
Mercy Hospital Springfield CurrentSince Apr 1, 2025 Accepting new patients
Skaggs Community Hospital Association CurrentSince Apr 21, 2025 Accepting new patients

Locations

2230 S Springfield Ave
Ste Hj
Bolivar, MO 65613
Phone (417) 777-4800

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

1300 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-7676

1240 N Butterfield Rd
Bolivar, MO 65613
Phone (417) 326-6021

322 E Hospital Rd
El Dorado Springs, MO 64744
Phone (417) 876-2118

855 Arduser Dr
Osceola, MO 64776
Phone (417) 646-5075

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1073916573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 NORTH OAKLAND AVE",
            "address_2": "CITIZENS MEMORIAL HOSPITAL",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "65613",
            "telephone_number": "417-326-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 NORTH OAKLAND AVE",
            "address_2": "CITIZENS MEMORIAL HOSPITAL",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "65613",
            "telephone_number": "417-326-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Branson Landing Blvd",
            "address_purpose": "LOCATION",
            "city": "Branson",
            "state": "MO",
            "postal_code": "656162052",
            "country_code": "US",
            "telephone_number": "417-335-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "SCOTT",
        "middle_name": "LESLIE",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-29",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2014027674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

Verify at the official NPI Registry.