Scott Eye Clinic PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

2349 Issued in AR

Legal business name

SCOTT EYE CLINIC PA

Practice address

214 E 4TH St
Russellville, AR 72801-5134

Phone

(479) 968-3937

Fax

(479) 967-6731

NPI assigned

Oct 11, 2007

Last updated

Feb 12, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Henry Keith Scott, ODNPI 1467487744

Title

Owner/Physician

Phone

(479) 968-3937

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Scott Eye Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Scott Eye Clinic PA

  • Optometrist
  • Danville, AR
  • NPI 1477123412
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Henry Keith Scott, OD

  • Optometrist
  • Russellville, AR
  • NPI 1467487744
  Medicare reassignment Care Compare group NPD Authorized official
• Justin Thomas Morden, O.D.

  • Optometrist
  • Russellville, AR
  • NPI 1881077675
  Medicare reassignment Care Compare group NPD
• Lauren Nelson Morden, OD

  • Optometrist
  • Russellville, AR
  • NPI 1801201264
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518393600000",
    "number": "1114115433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 E 4TH ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728015134",
            "telephone_number": "479-968-3937",
            "fax_number": "479-967-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 E 4TH ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728015134",
            "telephone_number": "479-968-3937",
            "fax_number": "479-967-6731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT EYE CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2018-02-12",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "479-968-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC",
            "identifier": "1114115433",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148782722",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146049722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valina G Schembra
• Joseph Schenck
• Nadjie Schiavo-Kendrick, CASE MANAGER PARA PR
• Sarah Schrimsher
• Rebecca L Schroeder, CASE MANAGER PARAPRO
• Henry Keith Scott, OD
• Kaely Scott
• Nancy Anne Scribner, OTRL
• Angela Scully
• Kassen Sears

• Optometrist in Russellville, AR
• Providers in Russellville, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.