Individual provider Active NPI

Henry Keith Scott, OD

  • Optometrist
  • Russellville, AR
National Provider Identifier
1467487744
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2349 Issued in AR
Practice address
214 East 4TH St
Russellville, AR 72801
Phone
(479) 968-3937
Fax
(479) 967-6731
NPI assigned
Jul 12, 2006
Last updated
Aug 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2349 AR Primary
Optometrist 152W00000X OD1100234 AR

Addresses

Primary practice location

214 East 4TH St
Russellville, AR 72801

Mailing address

214 East 4TH Street
Russellville, AR 72801
Phone (479) 968-3937

Other identifiers 1

IdentifierTypeStateIssuer
148782722MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20031209000554 AR Practitioner - Optometry 2466358643 Reassigns benefits to 1 organization
Receives reassigned benefits from 1 practitioner

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott Eye Clinic PAGroup PAC ID 3173735396, 3 clinicians

Practice addresses (Care Compare)

214 E 4TH St
Russellville, AR 72801-5134

740 Boston St
Danville, AR 72833-7006
Phone (479) 495-3937

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery74
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD1100234ARMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott Eye Clinic PA Optometrist CurrentSince Jul 21, 1985 Accepting new patients
Associated Anesthesiologists of Springfield Past Accepting new patients

Locations

740 Boston St
Danville, AR 72833
Phone (479) 495-3937

214 E 4th St
Russellville, AR 72801
Phone (479) 968-3937

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1467487744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 EAST 4TH STREET",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72801",
            "telephone_number": "479-968-3937",
            "fax_number": "479-967-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 EAST 4TH ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72801",
            "telephone_number": "479-968-3937",
            "fax_number": "479-967-6731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "HENRY",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2349",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "OD1100234",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148782722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.