Individual provider Active NPI

Edward Floyd Scammon, D.M.D.

  • General Practice Dentistry
  • Fayetteville, NC
National Provider Identifier
1306981550
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6537 Issued in NC
Practice address
8159 Raeford Rd
Fayetteville, NC 28304-5981
Phone
(910) 826-4900
Fax
(910) 826-4943
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6537 NC Primary

Addresses

Primary practice location

8159 Raeford Rd
Fayetteville, NC 28304-5981

Mailing address

8159 Raeford Rd
Fayetteville, NC 28304-5981
Phone (910) 826-4900

Other identifiers 1

IdentifierTypeStateIssuer
8997578MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140414000638 NC Practitioner - Oral Surgery 0648402214 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Edward F. Scammon DMD PA General Practice Current Accepting new patients
Edward F. Scammon DMD PA General Practice CurrentSince Sep 3, 1999 Accepting new patients

Locations

8159 Raeford Rd
Fayetteville, NC 28304
Phone (910) 208-4254

115 Southern Dunes Dr
Vass, NC 28394
Phone (910) 242-4577

Organizations & group practices 2

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306981550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8159 RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283045981",
            "telephone_number": "910-826-4900",
            "fax_number": "910-826-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8159 RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283045981",
            "telephone_number": "910-826-4900",
            "fax_number": "910-826-4943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCAMMON",
        "first_name": "EDWARD",
        "middle_name": "FLOYD",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8997578",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.