Kyle Scott

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6362009341 Issued in MI

Practice address

128 N Court Ave
Gaylord, MI 49735-1408

Phone

(989) 448-8344

NPI assigned

Aug 7, 2021

Last updated

Aug 7, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Old Town Psychological Services

  • Clinical Psychologist
  • Traverse City, MI
  • NPI 1093989162
  NPD (past)
• Old Town Psychological Services-Gaylord

  • Clinical Child & Adolescent Psychologist
  • Gaylord, MI
  • NPI 1750659249
  NPD (past)

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

{
    "created_epoch": "1628294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628294400000",
    "number": "1144994674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 N COURT AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351408",
            "telephone_number": "989-448-8344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 N COURT AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351408",
            "telephone_number": "989-448-8344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "512 S Union St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496843247",
            "country_code": "US",
            "telephone_number": "231-941-6550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "KYLE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-07",
        "last_updated": "2021-08-07",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6362009341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanette Sayre
• Peter Anthony Schaub, PT
• Daniel Schmidt, PT
• Sierra S Schreiber
• Katelynn Danielle Scott, PHARM. D.
• Christine Ann Seager, M.A. L.P.C.
• Mary B. Seger, N.P.
• Steven Richard Sella, DPM
• David Shammas, DDS
• Meriyah Raie Shampine, LLBSW

• Psychologist in Gaylord, MI
• Providers in Gaylord, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2021; 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.