Individual provider Active NPI

Kenneth G Scott, MD

  • Diagnostic Radiology Physician
  • Shelbyville, IN
National Provider Identifier
1275647646
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01049416 Issued in IN
Practice address
2451 Intelliplex Dr
Shelbyville, IN 46176-8580
Phone
(317) 392-3211
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01049416 IN Primary

Addresses

Primary practice location

2451 Intelliplex Dr
Shelbyville, IN 46176-8580

Mailing address

PO Box 58
Lima, OH 45802-0058
Phone (866) 942-0799

Other identifiers 1

IdentifierTypeStateIssuer
200386650AMedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kscott1275647646@direct.d4d.ihie.us

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20101102000983 IN Practitioner - Diagnostic Radiology 5799790705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Indiana University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
X-Ray Physicians of Shelbyville PCGroup PAC ID 2264420215, 43 clinicians

Practice addresses (Care Compare)

2451 Intelliplex Dr
Shelbyville, IN 46176-8580
Phone (317) 392-3211

7788 E 550
Needham, IN 46162-9746
Phone (903) 663-4800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01049416INMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Current Accepting new patients
Early Detection Imaging, LLC Diagnostic Radiology PastSince Mar 16, 2021 Accepting new patients

Locations

790 Creekview Dr
Columbus, IN 47201
Phone (812) 373-2113

2400 17th St
Columbus, IN 47201
Phone (812) 373-3025

2502 25th St
Columbus, IN 47201
Phone (812) 372-8883

10995 Allisonville Rd
#100
Fishers, IN 46038
Phone (317) 773-0008

10995 Allisonville Rd
Ste 100
Fishers, IN 46038
Phone (317) 842-7928

7340 Shadeland Sta
Ste 200
Indianapolis, IN 46256

7440 Woodland Dr
Indianapolis, IN 46278
Phone (317) 450-3357

9998 Crosspoint Blvd
Ste 200
Indianapolis, IN 46256

2451 Intelliplex Dr
Shelbyville, IN 46176
Phone (317) 392-3211

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 5

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1275647646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458020058",
            "telephone_number": "866-942-0799",
            "fax_number": "419-223-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 INTELLIPLEX DR",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768580",
            "telephone_number": "317-392-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "KENNETH",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01049416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200386650A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kscott1275647646@direct.d4d.ihie.us",
            "affiliation": "N",
            "address_1": "2451 Intelliplex Dr",
            "city": "Shelbyville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461768580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

Verify at the official NPI Registry.