Organization Active NPI

Scott J Loessin MD LLC

  • Plastic Surgery Physician
  • Daytona Beach, FL
National Provider Identifier
1275632176
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
ME0067948 Issued in FL
Legal business name
SCOTT J LOESSIN MD LLC
Practice address
311 N Clyde Morris Blvd
Suite 510
Daytona Beach, FL 32114-2781
Phone
(386) 258-3223
Fax
(386) 252-8237
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Authorized official

Name
Dr. Scott J Loessin, MD
Title
Physician
Phone
(386) 258-3223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X ME0067948 FL Primary

Addresses

Primary practice location

311 N Clyde Morris Blvd
Suite 510
Daytona Beach, FL 32114-2781

Mailing address

311 N Clyde Morris Blvd
510
Daytona Beach, FL 32114-2781
Phone (386) 258-3223

Other identifiers 1

IdentifierTypeStateIssuer
26863OtherFLBLUE CROSS/BLUE SHIELD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222300800000",
    "number": "1275632176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N CLYDE MORRIS BLVD",
            "address_2": "510",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142781",
            "telephone_number": "386-258-3223",
            "fax_number": "386-252-8237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N CLYDE MORRIS BLVD",
            "address_2": "SUITE 510",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142781",
            "telephone_number": "386-258-3223",
            "fax_number": "386-252-8237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT J LOESSIN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-09-25",
        "status": "A",
        "authorized_official_last_name": "LOESSIN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "386-258-3223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME0067948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "26863",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; 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.