Individual provider Active NPI

Craig D Scoville, MD

  • Rheumatology Physician
  • Idaho Falls, ID
National Provider Identifier
1194818997
Registry record updated Jul 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
M5232 Issued in ID
Practice address
2220 E 25TH St
Idaho Falls, ID 83404-7542
Phone
(208) 542-9080
Fax
(208) 542-9081
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X M5232 ID Primary

Addresses

Primary practice location

2220 E 25TH St
Idaho Falls, ID 83404-7542

Mailing address

2220 E 25TH St
Idaho Falls, ID 83404-7542
Phone (208) 542-9080

Other identifiers 1

IdentifierTypeStateIssuer
003958200MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20040609001030 ID Practitioner - RheumatologyPractitioner - Internal Medicine 4385627504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
University of Rochester School of Medicine and Dentistry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M5232IDMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Hospital LLC CurrentSince Jun 6, 2022 Accepting new patients
Mountain View Hospital Physician Organization Past Accepting new patients

Locations

2327 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-1000

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

2220 E 25th St
Idaho Falls, ID 83404
Phone (208) 523-1122

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 7

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373587200000",
    "number": "1194818997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 E 25TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047542",
            "telephone_number": "208-542-9080",
            "fax_number": "208-542-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 E 25TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047542",
            "telephone_number": "208-542-9080",
            "fax_number": "208-542-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOVILLE",
        "first_name": "CRAIG",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "ID",
            "license": "M5232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003958200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.