Individual provider Active NPI

Scott R Price, DPM

  • Podiatrist
  • Prescott Valley, AZ
National Provider Identifier
1417067455
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0564 Issued in AZ
Practice address
3149 N Windsong Dr
Prescott Valley, AZ 86314-2240
Phone
(928) 772-5916
Fax
(928) 775-3250
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0564 AZ Primary

Addresses

Primary practice location

3149 N Windsong Dr
Prescott Valley, AZ 86314-2240

Mailing address

3149 N Windsong Dr
Prescott Valley, AZ 86314-2240
Phone (928) 710-5014

Other identifiers 5

IdentifierTypeStateIssuer
35-2210138OtherAZAETNA
AZ0195490OtherAZBLUE CROSS BLUE SHIELD
P00198294OtherAZRAIL ROAD MEDICARE
35-2210138OtherAZAZ FOUNDATION
DC9191OtherAZRAIL RD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050107000804 AZ Practitioner - Podiatry 6406769744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Foot and Ankle, LLCGroup PAC ID 4082662853, 2 clinicians

Practice addresses (Care Compare)

3149 N Windsong Dr
Prescott Valley, AZ 86314-2240
Phone (928) 772-5916

Hospital & facility affiliations

  • Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue122
Removal of skin lesions1-10
Removal of nail tissue1443
Removal or shaving of skin growth1139
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0564AZMDPhysical Therapist
564AZMDElectroneurodiagnostic Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Foot and Ankle, L.L.C. Podiatrist CurrentSince Feb 18, 2004 Accepting new patients
Tri City Surgery Center LLC PastSince Apr 30, 2003 Accepting new patients
Prescott Foot & Ankle Clinic PC Past Accepting new patients

Locations

919 12th Pl
Ste 10
Prescott, AZ 86305
Phone (928) 445-4898

3149 N Windsong Dr
Prescott Vly, AZ 86314
Phone (928) 445-6083

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 1

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1417067455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3149 N WINDSONG DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142240",
            "telephone_number": "928-710-5014",
            "fax_number": "928-775-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3149 N WINDSONG DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142240",
            "telephone_number": "928-772-5916",
            "fax_number": "928-775-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "SCOTT",
        "middle_name": "R",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "0564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "35-2210138",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0195490",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00198294",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ FOUNDATION",
            "identifier": "35-2210138",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL RD  MEDICARE",
            "identifier": "DC9191",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

Verify at the official NPI Registry.