Scott C Dulebohn, M. D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

MD34821 Issued in TN

Practice address

410 N State of Franklin Rd
Suite 120
Johnson City, TN 37604-6971

Phone

(423) 431-2350

Fax

(423) 431-2372

NPI assigned

Jun 8, 2006

Last updated

Apr 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MN, TN, GU3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Neurosurgery

Education

University of Missouri, Columbia School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Guam Healthcare Development IncorporatedGroup PAC ID 9234351776, 211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Guam Regional Medical City Hospital, Dededo, GU, CCN 650003
• Guam Memorial Hospital Authority Hospital, Tamuning, GU, CCN 650001

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Guam Healthcare Development Incorporated

  dba GRMC Specialty Care Center

  • Clinic/Center
  • Dededo, GU
  • NPI 1326447939
  Medicare reassignment Care Compare group NPD
• Blue Ridge Medical Management Corporation

  dba First Assist Urgent Care

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  Medicare reassignment NPD
• Group Health, Inc.

  dba HealthPartners Medical Group

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment NPD
• Guam X-Ray

  dba Guam Radiology Consultants

  • Vascular & Interventional Radiology Physician
  • Tamuning, GU
  • NPI 1376767426
  Medicare reassignment NPD
• Group Health, Inc.

  dba HealthPartners Clinic Stillwater

  • Family Medicine Physician
  • Stillwater, MN
  • NPI 1245608454
  NPD
• Group Health, Inc.

  dba HealthPartners Midway Residency Dental

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Guam Healthcare Development Incorporated

  dba Guam Regional Medical City

  • General Acute Care Hospital
  • Dededo, GU
  • NPI 1194159525
  Care Compare affiliation
• Guam Memorial Hospital

  • General Acute Care Hospital
  • Oka Tamuning, GU
  • NPI 1366519027
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1528009198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N STATE OF FRANKLIN RD",
            "address_2": "SUITE 120",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046971",
            "telephone_number": "423-431-2350",
            "fax_number": "423-431-2372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N STATE OF FRANKLIN RD",
            "address_2": "SUITE 120",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046971",
            "telephone_number": "423-431-2350",
            "fax_number": "423-431-2372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULEBOHN",
        "first_name": "SCOTT",
        "middle_name": "C",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MN",
            "license": "40265",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "VA",
            "license": "0101247383",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "GU",
            "license": "MTL-2023-001",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "GU",
            "license": "M-2375",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TN",
            "license": "MD34821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q003378",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528009198",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN01A5",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TENNESSEE",
            "identifier": "4127300",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528009198",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3338931",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meredith A Dugger, LPN
• Robert William Dugger
• Toni Renee Dugger
• Erin L. Dula
• Kimberly D Dula, MSN, APRN, BC, FNP
• James Duncan, PT
• Parker Paul Duncan
• Richard W Duncan, MD
• Wendy Duncan
• Bonnie C Dunham, RD

• Neurological Surgery Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Neurological Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.