Individual provider Active NPI

Derek Scott, DO

  • Emergency Medicine Physician
  • Saint Joseph, MI
National Provider Identifier
1538626460
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5151016978 Issued in MI
Practice address
Lakeland Health-Gme
1234 Napier Ave
Saint Joseph, MI 49085
Phone
(269) 982-4941
NPI assigned
Feb 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X 0102206290 VA
Family Medicine Physician 207Q00000X 0102206290 VA
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 5151016978 MI Primary

Addresses

Primary practice location

Lakeland Health-Gme
1234 Napier Ave
Saint Joseph, MI 49085

Mailing address

Lakeland Health-Gme
1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

Other practice location 1

620 Paul Jones Circle
Portsmouth, VA 23708
Phone (757) 953-5000

Other practice location 2

Mobile Dive and Salvage Unit One
BLDG 17, Bishop Point
Pearl Harbor, HI 96860
Phone (808) 265-6865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240709004638 MI Order and Referring Only - Family PracticePractitioner - Family Practice 2668917139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102206290VAMDMilitary Health Care Provider

NPI Registry JSON

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1538626460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAKELAND HEALTH-GME",
            "address_2": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "49085",
            "telephone_number": "269-982-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAKELAND HEALTH-GME",
            "address_2": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "49085",
            "telephone_number": "269-982-4941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 Paul Jones Circle",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "23708",
            "country_code": "US",
            "telephone_number": "757-953-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Mobile Dive and Salvage Unit One",
            "address_2": "BLDG 17, Bishop Point",
            "address_purpose": "LOCATION",
            "city": "Pearl Harbor",
            "state": "HI",
            "postal_code": "96860",
            "country_code": "US",
            "telephone_number": "808-265-6865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-27",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "VA",
            "license": "0102206290",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102206290",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5151016978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.