NPIMap

Individual provider Active NPI

Scott Dennis Richards, PA-C

  • Medical Physician Assistant
  • Marion, VA
National Provider Identifier
1245388891
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110004884 Issued in VA
Practice address
601 Radio Hill Road
Mel Leaman Free Clinic at Emory & Henry College
Marion, VA 24354
Phone
(276) 781-2090
Fax
(207) 330-3955
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-138 ME
Medical Physician Assistant 363AM0700X PAN686 ME
Medical Physician Assistant 363AM0700X 0110004884 VA Primary

Addresses

Primary practice location

601 Radio Hill Road
Mel Leaman Free Clinic at Emory & Henry College
Marion, VA 24354

Mailing address

601 Radio Hill Road
Mel Leaman Free Clinic at Emory & Henry College
Marion, VA 24354
Phone (276) 781-2090

Other identifiers 1

IdentifierTypeStateIssuer
336160099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA-138MEMDPhysician Assistant
PAN686MEMDMedical Physician Assistant
0110004884VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Regional Medical Center Past Accepting new patients
Mel Leaman Free Clinic at Emory & Henry College, Inc. Past Accepting new patients
St. Mary'S Regional Medical Center Past Accepting new patients

Organizations & group practices 3

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1245388891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 RADIO HILL ROAD",
            "address_2": "MEL LEAMAN FREE CLINIC AT EMORY & HENRY COLLEGE",
            "city": "MARION",
            "state": "VA",
            "postal_code": "24354",
            "telephone_number": "276-781-2090",
            "fax_number": "207-783-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 RADIO HILL ROAD",
            "address_2": "MEL LEAMAN FREE CLINIC AT EMORY & HENRY COLLEGE",
            "city": "MARION",
            "state": "VA",
            "postal_code": "24354",
            "telephone_number": "276-781-2090",
            "fax_number": "207-330-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "SCOTT",
        "middle_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA-138",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ME",
            "license": "PAN686",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110004884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336160099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.