Individual provider Active NPI

Richard Lawrence Scott III, CRNA

  • Certified Registered Nurse Anesthetist
  • Mount Vernon, IL
National Provider Identifier
1245727197
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
119463 Issued in MO
Practice address
8 Doctors Park Rd
Mount Vernon, IL 62864-6224
Phone
(314) 722-6713
NPI assigned
Apr 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 119463 MO Primary

Addresses

Primary practice location

8 Doctors Park Rd
Mount Vernon, IL 62864-6224

Mailing address

2023 Vadalabene Dr Ste 300
Maryville, IL 62062-5846
Phone (314) 722-6713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181029003031 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143573758 Reassigns benefits to 2 organizations
I20210115000651 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143573758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro-West Anesthesia Group IncGroup PAC ID 2163329921, 204 clinicians
Missouri Baptist Medical CenterGroup PAC ID 3476461955, 123 clinicians

Practice addresses (Care Compare)

2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313
Phone (314) 453-0600

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
119463MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
G & G Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 28, 2020 Accepting new patients
Metro-West Anesthesia Group Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2024 Accepting new patients
Missouri Baptist Medical Center Nurse Anesthetist, Certified Registered CurrentSince Oct 21, 2024 Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

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.

Hospital & facility affiliations 3

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": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1245727197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 VADALABENE DR STE 300",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625846",
            "telephone_number": "314-722-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 DOCTORS PARK RD",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646224",
            "telephone_number": "314-722-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "RICHARD",
        "middle_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-17",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "119463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.