NPIMap

Individual provider Active NPI

Kenneth L Scott, DO

  • Hospitalist Physician
  • Chattanooga, TN
National Provider Identifier
1083699524
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
850 Issued in TN
Practice address
2525 Desales Ave
Chattanooga, TN 37404-1161
Phone
(423) 495-2620
Fax
(423) 495-7887
NPI assigned
Dec 7, 2005
Last updated
Jul 18, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 850 TN
Hospitalist Physician 208M00000X 850 TN Primary

Addresses

Primary practice location

2525 Desales Ave
Chattanooga, TN 37404-1161

Mailing address

2525 Desales Ave
Chattanooga, TN 37404-1161
Phone (423) 495-2620

Other identifiers 1

IdentifierTypeStateIssuer
056002413AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, HI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041207001087 TN Practitioner - Internal Medicine 5193781581
I20180111001191 HI Practitioner - Internal Medicine 5193781581 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

100 Keokea PL
Kula, HI 96790-7450
Phone (808) 878-1221

221 Mahalani St
Wailuku, HI 96793-2526
Phone (808) 244-9056

312 Hiolani St
Makawao, HI 96768-8423
Phone (808) 736-3129

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
850TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince Apr 8, 2018 Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince Apr 8, 2018 Accepting new patients
Kingsport Consultants Internal Medicine Past Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC Past Accepting new patients
Silversage Physician Services of South Carolina, PC Internal Medicine PastSince Feb 1, 2017 Accepting new patients
Life Care Centers of America, Inc. PastSince Aug 4, 2010 Accepting new patients
Cleveland Medical Clinic Inc Internal Medicine Past Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC Past Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC Past Accepting new patients

Locations

100 Keokea Pl
Kula, HI 96790
Phone (808) 875-6690

221 Mahalani St
Wailuku, HI 96793
Phone (808) 242-2290

Networks

  • HI PPO
  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kula Skilled Nursing and Intermediate Care FacilityKula, HI, CCN 125003 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2019
Jun 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1083699524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 DESALES AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041161",
            "telephone_number": "423-495-2620",
            "fax_number": "423-495-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 DESALES AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041161",
            "telephone_number": "423-495-2620",
            "fax_number": "423-495-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "KENNETH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "850",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056002413A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.