Scott Holliday, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01587 Issued in TX

Practice address

PSC 2 Box 14516
Apo, AE 09012-0146

Phone

(479) 855-7907

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

University of Wisconsin School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Otero County Hospital AssociationGroup PAC ID 3173516606, 245 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tri-State Memorial Hospital Hospital, Clarkston, WA, CCN 501332
• Christus Southern New Mexico Hospital, Alamogordo, NM, CCN 320004

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Otero County Hospital Association

  • General Acute Care Hospital
  • Alamogordo, NM
  • NPI 1861450579
  Medicare reassignment Care Compare group
• Four Corners Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Alamogordo, NM
  • NPI 1144793464
  Medicare reassignment
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1598814352
  Medicare reassignment
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1760485221
  Medicare reassignment
• Otero County Hospital Association

  • Community/Retail Pharmacy
  • Alamogordo, NM
  • NPI 1235948803
  NPD
• Texas Em-I Medical Services, PA

  • Internal Medicine Physician
  • Greenville, TX
  • NPI 1699981720
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Otero County Hospital Association

  • General Acute Care Hospital
  • Alamogordo, NM
  • NPI 1861450579
  Care Compare affiliation
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1760485221
  Care Compare affiliation
• Tri-State Memorial Hospital

  • Family Medicine Physician
  • Clarkston, WA
  • NPI 1932405693

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1215077797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "PSC 2 BOX 14516",
            "city": "APO",
            "state": "AE",
            "postal_code": "090120146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "PSC 2 BOX 14516",
            "city": "APO",
            "state": "AE",
            "postal_code": "090120146",
            "telephone_number": "479-855-7907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIDAY",
        "first_name": "SCOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103572",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.

Verify at the official NPI Registry.