Individual provider Active NPI

Elisabeth Scott, MD

  • Family Medicine Physician
  • Canby, OR
National Provider Identifier
1124094099
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD154529 Issued in OR
Practice address
178 SW 2ND Ave
Canby, OR 97013-4152
Phone
(503) 416-1960
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2002-01525 NC
Family Medicine Physician 207Q00000X MD154529 OR Primary

Addresses

Primary practice location

178 SW 2ND Ave
Canby, OR 97013-4152

Mailing address

6420 SW Macadam Ave
300
Portland, OR 97239-3507

Other identifiers 1

IdentifierTypeStateIssuer
500635004MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2002-01525NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Medical Associates, PA PastSince Sep 1, 1998 Accepting new patients
Lenoir HM Services LLC Past Accepting new patients
Neighborhood Health Center Family Medicine Past Accepting new patients
Neighborhood Health Center Family Medicine Past Accepting new patients
Eastern Medical Associates, PA Family Medicine Past Accepting new patients

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1124094099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 SW MACADAM AVE",
            "address_2": "300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 SW 2ND AVE",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970134152",
            "telephone_number": "503-416-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "ELISABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2002-01525",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD154529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500635004",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canby, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.