Individual provider Active NPI

Carol L Scott, O.D.

  • Optometrist
  • Springfield, MO
National Provider Identifier
1467577866
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
D02560 Issued in MO
Practice address
1426 E Bradford Pkwy
Springfield, MO 65804-6563
Phone
(417) 887-7151
Fax
(417) 887-7151
NPI assigned
Mar 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X D02560 MO Primary

Addresses

Primary practice location

1426 E Bradford Pkwy
Springfield, MO 65804-6563

Mailing address

1426 E Bradford Pkwy
Springfield, MO 65804-6563
Phone (417) 887-7151

Other identifiers 1

IdentifierTypeStateIssuer
312243819MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20100914000306 MO Practitioner - Optometry 2769507805 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bolivar Vision, LLC Optometrist CurrentSince Sep 5, 2024 Accepting new patients
Pierce Vision Specialists, LLC Optometrist PastSince Jan 1, 2013 Accepting new patients
Missouri Eye Institute LLC Optometrist PastSince Sep 5, 2024 Accepting new patients
Vision Clinic PC Optometrist PastSince Sep 4, 2013 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

680 E Aldrich Rd
Bolivar, MO 65613
Phone (417) 777-9000

Organizations & group practices 6

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467577866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046563",
            "telephone_number": "417-887-7151",
            "fax_number": "417-887-7151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046563",
            "telephone_number": "417-887-7151",
            "fax_number": "417-887-7151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "CAROL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "D02560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "312243819",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.