Active NPI
Kelley L Scott, NP
- Nurse Practitioner
- Fullerton, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NP11343
- Practice address
- 1835 Sunny Crest Dr
Fullerton, CA 92835-3616 - Phone
- (714) 446-5101
- NPI assigned
- Jun 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NP11343 | CA | Primary |
Addresses
Primary practice location
1835 Sunny Crest Dr
Fullerton, CA 92835-3616
Mailing address
1835 Sunny Crest Dr
Fullerton, CA 92835-3616
Phone (714) 446-5101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11343 | CA | MD | Speech-Language Pathologist |
| NP11343 | CA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| Pathway Medical Group, Inc. | Past | Accepting new patients | |
| St Jude Hospital Inc | Past | Accepting new patients | |
| Providence Medical Foundation | Past | Accepting new patients |
Locations
200 W Ctr St Promenade
Anaheim, CA 92805
Phone (714) 449-4841
200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841
1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835
100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200
1835 Sunny Crest Dr
Fullerton, CA 92835
Phone (714) 446-5101
Organizations & group practices 6
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.
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- Family Medicine Physician
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- NPI 1871607762
-
- General Practice Physician
- Diamond Bar, CA
- NPI 1285890624
-
- Family Medicine Physician
- Mission Viejo, CA
- NPI 1427305960
-
- Family Medicine Physician
- Anaheim, CA
- NPI 1639715709
-
- Internal Medicine Physician
- Anaheim, CA
- NPI 1407199243
-
- General Acute Care Hospital
- Fullerton, CA
- NPI 1194926279
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655164800000",
"number": "1366487522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1835 SUNNY CREST DR",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928353616",
"telephone_number": "714-446-5101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1835 SUNNY CREST DR",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928353616",
"telephone_number": "714-446-5101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "KELLEY",
"middle_name": "L",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-19",
"last_updated": "2022-06-14",
"certification_date": "2022-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "NP11343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.