Kevin S Scully, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

28340 Issued in NC

Practice address

2716 Ashton Dr
Wilmington, NC 28412-2489

Phone

(910) 332-3800

Fax

(910) 251-0421

NPI assigned

Apr 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: kevin.scully.1@14070.direct.athenahealth.com

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1114983772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 ASHTON DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122489",
            "telephone_number": "910-332-3800",
            "fax_number": "910-251-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 ASHTON DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122489",
            "telephone_number": "910-332-3800",
            "fax_number": "910-251-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLY",
        "first_name": "KEVIN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "28340",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NC",
            "license": "28340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8975089",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01048395",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Charles Scott, LCSW
• Kasey Lynn Scott, DMD
• Kathleen Scott, LCSW
• Shelby Scott
• Mary Scoville, M.ED., CCC-SLP
• Kailee Alexis Scurpa, PHARMD
• SE Wellness & Behavioral Health, PLLC
• Sea Bright, Inc
• Sea Coast Physical Therapy, Inc
• Sea Glass Counseling Collaborative LLC

• Sports Medicine (Orthopaedic Surgery) Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.