Individual provider Active NPI

Richard Ralph Scallion, MD

  • Surgery Physician
  • Bolivia, NC
National Provider Identifier
1215047543
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
200700127 Issued in NC
Practice address
257 Hospital Drive Suite 200
Bolivia, NC 28422-8411
Phone
(910) 721-4000
Fax
(910) 721-4001
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 29512 TN
Surgery Physician 208600000X 200700127 NC Primary

Addresses

Primary practice location

257 Hospital Drive Suite 200
Bolivia, NC 28422-8411

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-7840

Other practice location 1

584 Hospital Dr
Suite A
Bolivia, NC 28422
Phone (910) 721-4000

Other identifiers 1

IdentifierTypeStateIssuer
5905853MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rscallion16737@direct.novanthealth.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070510000275 NC Practitioner - General Surgery 7214952506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Georgia School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

584 Hospital Dr NE
Unit a
Bolivia, NC 28422-0020
Phone (810) 721-4200

Hospital & facility affiliations

  • Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158
  • Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)23
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200700127NCMDSurgery Physician
29512TNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

330 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 316-2350

Interoperability endpoints

  • Direct secure messaging: rscallion16737@direct.novanthealth.org

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
Novant Health Brunswick Medical CenterBolivia, NC, CCN 340158 Hospital Corporate Director Jan 28, 2014

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 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 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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1215047543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-7840",
            "fax_number": "704-384-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 HOSPITAL DRIVE SUITE 200",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228411",
            "telephone_number": "910-721-4000",
            "fax_number": "910-721-4001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "584 Hospital Dr",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Bolivia",
            "state": "NC",
            "postal_code": "28422",
            "country_code": "US",
            "telephone_number": "910-721-4000",
            "fax_number": "910-721-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCALLION",
        "first_name": "RICHARD",
        "middle_name": "RALPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "29512",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "200700127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905853",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rscallion16737@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "584 Hospital Dr",
            "address_2": "Suite A",
            "city": "Bolivia",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bolivia, NC

Sources for this page

Verify at the official NPI Registry.