Active NPI
Nicole Scott
- Psychiatry Physician
- Austin, TX
National Provider Identifier
1396278248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- S3873
- Practice address
- 4022 Menchaca Rd
Austin, TX 78704-6746 - Phone
- (512) 982-4116
- Fax
- (512) 265-5900
- NPI assigned
- Apr 7, 2017
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | S3873 | TX | Primary |
Addresses
Primary practice location
4022 Menchaca Rd
Austin, TX 78704-6746
Mailing address
4022 Menchaca Rd
Austin, TX 78704-6746
Phone (512) 982-4116
Other names 1
- Nicole Victoria Peterson
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S3873 | TX | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628726400000",
"number": "1396278248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4022 MENCHACA RD",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787046746",
"telephone_number": "512-982-4116",
"fax_number": "512-265-9008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4022 MENCHACA RD",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787046746",
"telephone_number": "512-982-4116",
"fax_number": "512-265-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-07",
"last_updated": "2021-08-12",
"certification_date": "2021-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "S3873",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "PETERSON",
"middle_name": "VICTORIA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.