Active NPI
Scott Anthony Crollard, MD
- Emergency Medicine Physician
- Washington, MO
National Provider Identifier
1477626414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD102926
- Practice address
- 901 E 5TH St
Mercy Hospital Washington
Washington, MO 63090-3127 - Phone
- (636) 239-8011
- Fax
- (636) 239-8058
- NPI assigned
- Nov 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD102926 | MO | Primary |
Addresses
Primary practice location
901 E 5TH St
Mercy Hospital Washington
Washington, MO 63090-3127
Mailing address
12107 Westwick Place
St Louis, MO 63127
Phone (314) 842-2179
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD102926 | MO | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Health Care St Louis | Emergency Medicine | Past | Accepting new patients |
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.
-
dba SSM Health St Clare Fenton
- Emergency Medicine Physician
- Fenton, MO
- NPI 1275586174
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361923200000",
"number": "1477626414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12107 WESTWICK PLACE",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63127",
"telephone_number": "314-842-2179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 E 5TH ST",
"address_2": "MERCY HOSPITAL WASHINGTON",
"city": "WASHINGTON",
"state": "MO",
"postal_code": "630903127",
"telephone_number": "636-239-8011",
"fax_number": "636-239-8058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROLLARD",
"first_name": "SCOTT",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2013-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MO",
"license": "MD102926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.