Individual provider Active NPI

Scott A Carlos, MD

  • Family Medicine Physician
  • Wheeling, WV
National Provider Identifier
1437140670
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23792 Issued in SC
Practice address
40 Medical Park
Suite 401
Wheeling, WV 26003-6392
Phone
(304) 243-3880
Fax
(304) 243-3895
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23792 SC Primary

Addresses

Primary practice location

40 Medical Park
Suite 401
Wheeling, WV 26003-6392

Mailing address

40 Medical Park
Suite 401
Wheeling, WV 26003-6392
Phone (304) 243-3880

Other identifiers 1

IdentifierTypeStateIssuer
T79956MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20080603000161 WV Practitioner - Family PracticePractitioner - Geriatric Medicine 9638249618

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23792SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wheeling Hospital, Inc. Past Accepting new patients
Medexpress Urgent Care PLLC-Morgantown Past Accepting new patients
Medexpress Urgent Care, PC - Monaca Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1437140670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MEDICAL PARK",
            "address_2": "SUITE 401",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036392",
            "telephone_number": "304-243-3880",
            "fax_number": "304-243-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MEDICAL PARK",
            "address_2": "SUITE 401",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036392",
            "telephone_number": "304-243-3880",
            "fax_number": "304-243-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLOS",
        "first_name": "SCOTT",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "23792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T79956",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.