Individual provider Active NPI

Scott Blume Gremillion, MD.

  • Geriatric Medicine (Internal Medicine) Physician
  • Alexandria, LA
National Provider Identifier
1356454664
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
014739 Issued in LA
Practice address
Highway 165 North
Alexandria, LA 71306-9004
Phone
(318) 473-0010
Fax
(318) 483-5129
NPI assigned
Aug 17, 2006
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
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 014739 LA Primary

Addresses

Primary practice location

Highway 165 North
Alexandria, LA 71306-9004

Mailing address

6201 Cobblestone Dr
Alexandria, LA 71303-2057
Phone (318) 448-0478

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014739LAMDGeriatric Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356454664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 COBBLESTONE DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032057",
            "telephone_number": "318-448-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 165 NORTH",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713069004",
            "telephone_number": "318-473-0010",
            "fax_number": "318-483-5129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREMILLION",
        "first_name": "SCOTT",
        "middle_name": "BLUME",
        "name_prefix": "Dr.",
        "credential": "MD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "LA",
            "license": "014739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.