Active NPI
Roxane W Scott, MD
- Psychiatry Physician
- Summerville, SC
National Provider Identifier
1093807620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 20769
- Practice address
- 106 Springview LN
Summerville, SC 29485-8108 - Phone
- (843) 873-5063
- NPI assigned
- Sep 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 20769 | SC | Primary |
Addresses
Primary practice location
106 Springview LN
Summerville, SC 29485-8108
Mailing address
9229 University Blvd
BLDG F Ste 2-a
North Charleston, SC 29406
Phone (843) 789-6975
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 190166 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151015002257 | SC | Order and Referring Only - Psychiatry | 3274714092 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443312000000",
"number": "1093807620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9229 UNIVERSITY BLVD",
"address_2": "BLDG F STE 2-A",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "29406",
"telephone_number": "843-789-6975",
"fax_number": "843-572-8135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 SPRINGVIEW LN",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294858108",
"telephone_number": "843-873-5063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "ROXANE",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-29",
"last_updated": "2015-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "SC",
"license": "20769",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "190166",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Summerville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.