Individual provider Active NPI

Mark A Scott, DC

  • Chiropractor
  • Virginia Beach, VA
National Provider Identifier
1356412175
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001533 Issued in VA
Practice address
1801 Pleasurehouse Rd
105
Virginia Beach, VA 23455
Phone
(757) 363-8571
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

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
Chiropractor 111N00000X 0104001533 VA Primary

Addresses

Primary practice location

1801 Pleasurehouse Rd
105
Virginia Beach, VA 23455

Mailing address

1801 Pleasurehouse Rd
105
Virginia Beach, VA 23455
Phone (757) 363-8571

Other identifiers 2

IdentifierTypeStateIssuer
000300365MedicaidVA
118947OtherVABX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110524000191 VA Practitioner - Chiropractic 2264623495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1801 Pleasure House Rd
Suite 105
Virginia Beach, VA 23455-2864

1801 Pleasure House Rd
Suite 105
Virginia Beach, VA 23455-2990
Phone (757) 363-8571

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104001533VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Beach Medical Group PC Chiropractor CurrentSince Feb 1, 2000 Accepting new patients
Beach Medical Group, PC Chiropractor Past Accepting new patients

Locations

1801 Pleasure House Rd
Ste 105
Virginia Beach, VA 23455
Phone (757) 363-8571

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356412175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 PLEASUREHOUSE RD",
            "address_2": "105",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23455",
            "telephone_number": "757-363-8571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 PLEASUREHOUSE RD",
            "address_2": "105",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23455",
            "telephone_number": "757-363-8571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000300365",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BX",
            "identifier": "118947",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.