Individual provider Active NPI

Scott Kanagy, DO

  • Emergency Medicine Physician
  • Crown Point, IN
National Provider Identifier
1194781781
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
02001963A Issued in IN
Practice address
1201 S Main St
Dept: Ed
Crown Point, IN 46307-8481
Phone
(219) 757-6310
Fax
(219) 757-6312
NPI assigned
Apr 24, 2006
Last updated
Aug 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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 02001963A IN Primary

Addresses

Primary practice location

1201 S Main St
Dept: Ed
Crown Point, IN 46307-8481

Mailing address

1201 S Main St
Dept: Ed
Crown Point, IN 46307-8481
Phone (219) 757-6310

Other identifiers 1

IdentifierTypeStateIssuer
200392360MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260422001717 OH Practitioner - Emergency Medicine 9830384320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2038 Lariat CT
Centerville, OH 45458-2595

4535 Dressier Rd NW
Canton, OH 44718-2545

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Anthony Medical Center Past Accepting new patients
Webster Emergency Physicians Emergency Medicine Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Atrium Medical CenterMiddletown, OH, CCN 360076 Hospital Corporate Director May 25, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1194781781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S MAIN ST",
            "address_2": "DEPT: ED",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078481",
            "telephone_number": "219-757-6310",
            "fax_number": "219-757-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MAIN ST",
            "address_2": "DEPT: ED",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078481",
            "telephone_number": "219-757-6310",
            "fax_number": "219-757-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAGY",
        "first_name": "SCOTT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02001963A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200392360",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.