Individual provider Active NPI

Jonette Scott, M.D.

  • Pediatrics Physician
  • Gulfport, MS
National Provider Identifier
1083714612
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
12293 Issued in MS
Practice address
15024 Martin Luther King Jr Blvd
Gulfport, MS 39501-8306
Phone
(228) 864-0003
Fax
(228) 863-7917
NPI assigned
Sep 24, 2006
Last updated
Aug 25, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 12293 MS Primary

Addresses

Primary practice location

15024 Martin Luther King Jr Blvd
Gulfport, MS 39501-8306

Mailing address

PO Box 475
Biloxi, MS 39533-0475
Phone (228) 374-2494

Other identifiers 1

IdentifierTypeStateIssuer
00012401MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050222000542 MS Practitioner - Pediatric Medicine 2668425430 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Family Health Center, Inc CurrentSince Oct 8, 2006 Accepting new patients
Coastal Family Health Center, Inc CurrentSince Oct 8, 2006 Accepting new patients
Coastal Family Health Center, Inc Current Accepting new patients

Locations

1046 Division St
Biloxi, MS 39530
Phone (225) 374-2494

15024 Mlk
Gulfport, MS 39501
Phone (228) 846-0003

Interoperability endpoints

  • Direct secure messaging: jscott@direct.mhg.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1083714612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 475",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395330475",
            "telephone_number": "228-374-2494",
            "fax_number": "228-374-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15024 MARTIN LUTHER KING JR BLVD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395018306",
            "telephone_number": "228-864-0003",
            "fax_number": "228-863-7917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "JONETTE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "12293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00012401",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.