Active NPI
Kermith Scarlett, D.O.
- Family Medicine Physician
- Lansing, MI
National Provider Identifier
1205015278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- KS009329
- Practice address
- 1808 S Pennsylvania Ave
Ste a
Lansing, MI 48910-1897 - Phone
- (517) 268-6608
- Fax
- (517) 268-6609
- NPI assigned
- Oct 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | KS009329 | MI | Primary |
Addresses
Primary practice location
1808 S Pennsylvania Ave
Ste a
Lansing, MI 48910-1897
Mailing address
PO Box 23068
Lansing, MI 48909-3068
Phone (517) 267-1270
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3105211 | Medicaid | MI | |
| KS009329 | Other | MI | LIC # |
| 0153303015 | Other | MI | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040831000234 | MI | Practitioner - Family Practice | 6608841986 | Practice locations: Lansing, MI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KS009329 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484006400000",
"number": "1205015278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23068",
"city": "LANSING",
"state": "MI",
"postal_code": "489093068",
"telephone_number": "517-267-1270",
"fax_number": "517-267-1272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1808 S PENNSYLVANIA AVE",
"address_2": "STE A",
"city": "LANSING",
"state": "MI",
"postal_code": "489101897",
"telephone_number": "517-268-6608",
"fax_number": "517-268-6609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCARLETT",
"first_name": "KERMITH",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-26",
"last_updated": "2017-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "KS009329",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3105211",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIC #",
"identifier": "KS009329",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0153303015",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.