Individual provider Active NPI

Mary Kathryn Scaggs

  • Family Nurse Practitioner
  • Williamsburg, VA
National Provider Identifier
1376290429
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024183770 Issued in VA
Practice address
1600 Richmond Rd
Williamsburg, VA 23185-2724
Phone
(757) 229-0015
NPI assigned
Mar 8, 2022
Last updated
Mar 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024183770 VA Primary

Addresses

Primary practice location

1600 Richmond Rd
Williamsburg, VA 23185-2724

Mailing address

1600 Richmond Rd
Williamsburg, VA 23185-2724
Phone (757) 229-0015

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220628000690 VA Practitioner - Nurse Practitioner 0042698805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5424 Discovery Park Blvd
Williamsburg, VA 23188-2862
Phone (757) 327-0657

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Feb 1, 2023 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Feb 1, 2023 Accepting new patients
Tidewater Physicians Multispecialty Group PC PastSince Nov 16, 2021 Accepting new patients

Locations

11761 Rock Landing Dr
Ste 8
Newport News, VA 23606

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

827 Diligence Dr
Ste 100
Newport News, VA 23606

132 Professional Cir
Williamsburg, VA 23185
Phone (757) 232-8764

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1376290429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 RICHMOND RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852724",
            "telephone_number": "757-229-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 RICHMOND RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852724",
            "telephone_number": "757-229-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCAGGS",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024183770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.