Active NPI
David Allen Scruggs, PA
- Physician Assistant
- Carrollton, GA
National Provider Identifier
1205158383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2760
- Practice address
- 150 Clinic Ave
Suite 101
Carrollton, GA 30117-4401 - Phone
- (770) 834-0873
- NPI assigned
- Feb 17, 2010
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2760 | GA | Primary |
Addresses
Primary practice location
150 Clinic Ave
Suite 101
Carrollton, GA 30117-4401
Mailing address
150 Clinic Ave
Suite 101
Carrollton, GA 30117-4401
Phone (770) 834-0873
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Medical College of Georgia School of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
150 Clinic Ave
Carrollton, GA 30117-4498
Phone (770) 834-0873
150 Clinic Ave
Suite 101
Carrollton, GA 30117-4401
150 Clinic Ave
Suite 101
Carrollton, GA 30117-4402
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266364800000",
"number": "1205158383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 CLINIC AVE",
"address_2": "SUITE 101",
"city": "CARROLLTON",
"state": "GA",
"postal_code": "301174401",
"telephone_number": "770-834-0873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 CLINIC AVE",
"address_2": "SUITE 101",
"city": "CARROLLTON",
"state": "GA",
"postal_code": "301174401",
"telephone_number": "770-834-0873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCRUGGS",
"first_name": "DAVID",
"middle_name": "ALLEN",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-02-17",
"last_updated": "2010-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "2760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carrollton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.