Individual provider Active NPI

Scott Ethan Kilpatrick, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Winston-Salem, NC
National Provider Identifier
1356317846
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
36548 Issued in NC
Practice address
3333 Silas Creek Pkwy
Winston-Salem, NC 27103-3013
Phone
(336) 718-3737
Fax
(336) 718-9545
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 36548 NC Primary

Addresses

Primary practice location

3333 Silas Creek Pkwy
Winston-Salem, NC 27103-3013

Mailing address

PO Box 100559
Florence, SC 29501-0559
Phone (843) 664-4300

Other identifiers 1

IdentifierTypeStateIssuer
8948968MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20161012002498 OH Practitioner - Pathology 4284738725 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Medical College of Georgia School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

18901 Lake Shore Blvd
Euclid, OH 44119-1078
Phone (216) 531-9000

3050 Science Park Dr
BLDG 3
Beachwood, OH 44122-7316
Phone (866) 223-2273

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Medina Hospital Hospital, Medina, OH, CCN 360091
  • Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230
  • Cleveland Clinic Avon Hospital Hospital, Avon, OH, CCN 360364
  • Fairview Hospital Hospital, Cleveland, OH, CCN 360077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36548NCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Aug 16, 2016 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Aug 16, 2016 Accepting new patients
Wooster Clinic, LLC CurrentSince Dec 18, 2016 Accepting new patients
Pathologists Diagnostic Laboratory PA PastSince Dec 31, 2006 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

18901 Lake Shore Blvd
Euclid, OH 44119
Phone (216) 531-9000

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

Organizations & group practices 4

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1356317846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100559",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295010559",
            "telephone_number": "843-664-4300",
            "fax_number": "843-664-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-718-3737",
            "fax_number": "336-718-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILPATRICK",
        "first_name": "SCOTT",
        "middle_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "36548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8948968",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston-Salem, NC

Sources for this page

Verify at the official NPI Registry.