Active NPI
John Mo. Scott, D.D.S.
- Dentist
- Tyler, TX
National Provider Identifier
1508974965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9546
- Practice address
- 518 So Spring
Tyler, TX 75701 - Phone
- (903) 597-1528
- NPI assigned
- Aug 27, 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 9546 | TX | Primary |
Addresses
Primary practice location
518 So Spring
Tyler, TX 75701
Mailing address
504 Winchester
Tyler, TX 75701
Phone (903) 581-6552
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BO9546 | Other | TX | CHIPS |
| 008595301 | Medicaid | TX |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9546 | TX | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317772800000",
"number": "1508974965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 WINCHESTER",
"city": "TYLER",
"state": "TX",
"postal_code": "75701",
"telephone_number": "903-581-6552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "518 SO SPRING",
"city": "TYLER",
"state": "TX",
"postal_code": "75701",
"telephone_number": "903-597-1528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "JOHN",
"middle_name": "MO.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-27",
"last_updated": "2011-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "9546",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHIPS",
"identifier": "BO9546",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008595301",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.