Individual provider Active NPI

Scott Boerth, M.D.

  • Internal Medicine Physician
  • Blacksburg, VA
National Provider Identifier
1366439721
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101226430 Issued in VA
Practice address
3698 S Main St
Blacksburg, VA 24060-7015
Phone
(540) 951-6070
Fax
(540) 951-6071
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101226430 VA Primary

Addresses

Primary practice location

3698 S Main St
Blacksburg, VA 24060-7015

Mailing address

2000 Health Park Dr FL HP2
Brentwood, TN 37027-4692
Phone (615) 373-7600

Other identifiers 3

IdentifierTypeStateIssuer
1366439721MedicaidVA
005846129MedicaidVA
010287910MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address SCOTT.BOERTH@hca6.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20070323000274 VA Practitioner - Internal MedicinePractitioner - Emergency Medicine 7315041795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
University of South Alabama College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lewis Gale Physicians LLCGroup PAC ID 6507886231, 191 clinicians

Practice addresses (Care Compare)

133 Bostic LN
Pembroke, VA 24136-3678
Phone (540) 808-8913

Hospital & facility affiliations

  • Warm Hearth at Home Inc Home health agency, Christiansburg, VA, CCN 497733
  • Lewisgale Hospital Montgomery Hospital, Blacksburg, VA, CCN 490110
  • Lewisgale Medical Center Hospital, Salem, VA, CCN 490048
  • Princeton Community Hospital Assn Inc Hospital, Princeton, WV, CCN 510046
  • The Wybe and Marietje Kroontje Health Care Center Nursing home, Blacksburg, VA, CCN 495406

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101226430VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis Gale Physicians LLC Internal Medicine CurrentSince Jul 20, 2019 Accepting new patients
Southeastern Physician Services PC Internal Medicine Past Accepting new patients
Montgomery Hospitalists LLC Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

2000 Health Park Dr
Fl HP2
Brentwood, TN 37027

3700 S Main St
Blacksburg, VA 24060
Phone (540) 951-1111

1645 N Main St
Blacksburg, VA 24060
Phone (540) 552-1246

3698 S Main St
Blacksburg, VA 24060
Phone (540) 951-6070

133 Bostic Ln
Pembroke, VA 24136
Phone (540) 921-4343

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

1802 Braeburn Dr
Salem, VA 24153
Phone (540) 772-3400

Interoperability endpoints

  • Direct secure messaging: scott.boerth@hca6.eclinicaldirectplus.com

Organizations & group practices 3

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1366439721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR FL HP2",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274692",
            "telephone_number": "615-373-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3698 S MAIN ST",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607015",
            "telephone_number": "540-951-6070",
            "fax_number": "540-951-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERTH",
        "first_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2022-02-08",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101226430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366439721",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005846129",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010287910",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SCOTT.BOERTH@hca6.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "3698 S Main St",
            "city": "Blacksburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240607015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

Verify at the official NPI Registry.