Individual provider Active NPI

Scotesia Y Dunlap

  • Physician Assistant
  • Reidsville, NC
National Provider Identifier
1164279345
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-14813 Issued in NC
Practice address
618 S Main St
Reidsville, NC 27320-5020
Phone
(336) 951-4823
NPI assigned
May 4, 2024
Last updated
Nov 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 0010-14813 NC Primary

Addresses

Primary practice location

618 S Main St
Reidsville, NC 27320-5020

Mailing address

PO Box 34
Norwood, NC 28128-0034
Phone (704) 796-3175

Other practice location 1

100 Church St S Ste A230
New Haven, CT 06519-1703
Phone (203) 737-2284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250103001062 NC Practitioner - Physician Assistant 5193253185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

110 S Park Ter
Suite a
Eden, NC 27288-5351
Phone (336) 627-3878

1220 Magnolia St
Greensboro, NC 27401-1309

501 N Elam Ave
Greensboro, NC 27403-1118
Phone (336) 832-1000

509 E N Elam Ave
FL 3
Greensboro, NC 27403-1118
Phone (336) 832-1970

618 S Main St
Reidsville, NC 27320-5020
Phone (336) 938-0800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H. Cone Memorial Hospital Operating Corporation CurrentSince Jan 27, 2025 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Jan 27, 2025 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Past Accepting new patients

Locations

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

618 S Main St
Reidsville, NC 27320
Phone (336) 832-7965

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1714780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1164279345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34",
            "city": "NORWOOD",
            "state": "NC",
            "postal_code": "281280034",
            "telephone_number": "704-796-3175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 S MAIN ST",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205020",
            "telephone_number": "336-951-4823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Church St S Ste A230",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065191703",
            "country_code": "US",
            "telephone_number": "203-737-2284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNLAP",
        "first_name": "SCOTESIA",
        "middle_name": "Y",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-04",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, NC

Sources for this page

Verify at the official NPI Registry.