Eddie Lee Scott III, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

110830 Issued in IA

Practice address

1801 Hickman Rd
Des Moines, IA 50314-1597

Phone

(515) 282-2296

NPI assigned

May 28, 2020

Last updated

Jun 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Broadlawns Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1467447508
  Medicare reassignment NPD
• Broadlawns Medical Center

  • Pharmacy
  • Des Moines, IA
  • NPI 1013197060
  NPD
• Broadlawns Medical Center

  • Psychiatric Hospital Unit
  • Des Moines, IA
  • NPI 1962662379
  NPD (past)

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1336762079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141597",
            "telephone_number": "515-282-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 HICKMAN RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141597",
            "telephone_number": "515-282-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "EDDIE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-28",
        "last_updated": "2023-06-20",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IA",
            "license": "110830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Scoresby
• Scott B Neff Dopc (Central Iowa Orthopaedics)
• Abbie Nichole Scott, RD, LD
• Anna Scott
• David E Scott, O.D.
• Katherine L Scott, DNP, CPNP-PC
• Scottish Rite Park, Inc.
• Penny Denise Scroggins
• Richard Kent Scupham, MD
• Rebecca S Seabrooke, LMHCT

• Clinical Child & Adolescent Psychologist in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Clinical Child & Adolescent Psychologist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.