NPIMap

Individual provider Active NPI

Scott Syndergaard, DO

  • Emergency Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1144740663
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2019-02555 Issued in NC
Practice address
1638 Owen Dr # 138
Fayetteville, NC 28304-3424
Phone
(910) 615-4530
NPI assigned
Jun 26, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2019-02555 NC Primary

Addresses

Primary practice location

1638 Owen Dr # 138
Fayetteville, NC 28304-3424

Mailing address

1638 Owen Dr # 138
Fayetteville, NC 28304-3424
Phone (910) 615-4530

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210922001771 NC Practitioner - Emergency Medicine 0941574537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cfvhs Ed PhysiciansGroup PAC ID 2961316237, 27 clinicians

Practice addresses (Care Compare)

800 Tilghman Dr
Dunn, NC 28334-5510
Phone (910) 776-7190

Hospital & facility affiliations

  • Cape Fear Valley-Bladen County Hospital Hospital, Elizabethtown, NC, CCN 341315
  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019-02555NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cfvhs Ed Physicians Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Cfvhs Ed Physicians Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients

Locations

800 Tilghman Dr
Dunn, NC 28334
Phone (910) 230-7800

501 S Poplar St
Elizabethtown, NC 28337
Phone (910) 862-4043

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

1638 Owen Dr
#138
Fayetteville, NC 28304
Phone (910) 615-4530

Interoperability endpoints

  • Direct secure messaging: ssyndergaard28698@capefearvalley.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144740663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR # 138",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR # 138",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYNDERGAARD",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-26",
        "last_updated": "2022-07-21",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2019-02555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.