Individual provider Active NPI

Nicole Scott

  • Clinical Psychologist
  • Newport News, VA
National Provider Identifier
1477045532
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301017446 Issued in MI
Practice address
729 Thimble Shoals Blvd Ste 3a
Newport News, VA 23606-4217
Phone
(757) 295-7956
NPI assigned
Jun 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301017446 MI Primary

Addresses

Primary practice location

729 Thimble Shoals Blvd Ste 3a
Newport News, VA 23606-4217

Mailing address

729 Thimble Shoals Blvd Ste 3a
Newport News, VA 23606-4217
Phone (757) 295-7956

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240227004656 VA Practitioner - Clinical Psychologist 0648615856 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301017446MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chesterfield Family Guidance Center Clinical CurrentSince Jan 9, 2024 Accepting new patients

Locations

729 Thimble Shoals Blvd
Ste 3A
Newport News, VA 23606
Phone (757) 295-7956

6603 Irongate Sq
North Chesterfield, VA 23234

Organizations & group practices 1

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1477045532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 THIMBLE SHOALS BLVD STE 3A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064217",
            "telephone_number": "757-295-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 THIMBLE SHOALS BLVD STE 3A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064217",
            "telephone_number": "757-295-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301017446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.