Individual provider Active NPI

Thomas Malcolm Scott, D.O.

  • Family Medicine Physician
  • Garden City, MI
National Provider Identifier
1467440297
Registry record updated Jan 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101010296 Issued in MI
Practice address
30730 Ford Rd
Garden City, MI 48135-1803
Phone
(734) 421-7474
Fax
(734) 421-0961
NPI assigned
Oct 6, 2005
Last updated
Jan 13, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2010

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 5101010296 MI Primary

Addresses

Primary practice location

30730 Ford Rd
Garden City, MI 48135-1803

Mailing address

30730 Ford Rd
Garden City, MI 48135-1803
Phone (734) 421-7474

Other identifiers 1

IdentifierTypeStateIssuer
4344636MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100604001083 MI Practitioner - Family Practice 5991835746 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101010296MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Mercy Physician Practices CurrentSince Jan 1, 2018 Accepting new patients
St Mary Mercy Physician Practices CurrentSince Jan 1, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

14555 Levan Rd
Ste 112
Livonia, MI 48154
Phone (734) 712-1000

19000 St Joes Pkwy
Ste 310
Livonia, MI 48152
Phone (248) 743-4490

29105 Buckingham St
Ste 11
Livonia, MI 48154
Phone (734) 427-2222

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.

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263340800000",
    "number": "1467440297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30730 FORD RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481351803",
            "telephone_number": "734-421-7474",
            "fax_number": "734-421-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30730 FORD RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481351803",
            "telephone_number": "734-421-7474",
            "fax_number": "734-421-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "THOMAS",
        "middle_name": "MALCOLM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2010-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101010296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4344636",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, MI

Sources for this page

Verify at the official NPI Registry.