Individual provider Active NPI

Graham Scott

  • Pulmonary Disease Physician
  • Charlotte, NC
National Provider Identifier
1265481303
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25526 Issued in NC
Practice address
1350 S Kings Dr
Charlotte, NC 28207-2134
Phone
(704) 446-4490
NPI assigned
May 8, 2006
Last updated
Feb 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 25526 NC Primary
Pulmonary Disease Physician 207RP1001X 15376 SC

Addresses

Primary practice location

1350 S Kings Dr
Charlotte, NC 28207-2134

Mailing address

1350 S Kings Dr
Charlotte, NC 28207-2134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070426000040 SC Practitioner - Pulmonary Disease 2860596608 Reassigns benefits to 2 organizations
I20151123002215 NC Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 2860596608 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15376SCMDClinical Social Worker
25526NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Hospital, Inc. Pulmonary Disease CurrentSince Sep 3, 2010 Accepting new patients
Roper Hospital, Inc. Current Accepting new patients
Roper Hospital Inc. CurrentSince Sep 3, 2010 Accepting new patients
Carolinas Medical Center CurrentSince Nov 9, 2015 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Vibra Physicians LLC CurrentSince Feb 7, 2017 Accepting new patients
Carolinas Medical Center CurrentSince Nov 9, 2015 Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

1200 Hospital Dr
Mt Pleasant, SC 29464
Phone (843) 226-7721

416 Robertson Blvd
Ste B
Walterboro, SC 29488
Phone (843) 549-2411

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1265481303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072134",
            "telephone_number": "704-446-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "GRAHAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "25526",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "SC",
            "license": "15376",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.