Individual provider Active NPI

Scott Brandon Webster, PA

  • Physician Assistant
  • Cornelius, NC
National Provider Identifier
1568448173
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102267 Issued in NC
Practice address
19485 Old Jetton Rd Ste 210
Cornelius, NC 28031-6592
Phone
(704) 316-1830
NPI assigned
Dec 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 102267 NC Primary

Addresses

Primary practice location

19485 Old Jetton Rd Ste 210
Cornelius, NC 28031-6592

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 358-0308

Other practice location 1

2826 Randolph Rd
Charlotte, NC 28211-1019
Phone (704) 358-0308

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address swebster78572@direct.novanthealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090603000187 NC Practitioner - Physician Assistant 0648329615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
May accept Medicare assignment
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Practice addresses (Care Compare)

1901 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 316-2000

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

4741 Randolph Rd
Charlotte, NC 28211-2919
Phone (704) 365-6730

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jun 1, 2009 Accepting new patients
Novant Medical Group, Inc CurrentSince Jun 1, 2009 Accepting new patients
Novant Medical Group Inc CurrentSince Jun 1, 2009 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

4741 Randolph Rd
#100
Charlotte, NC 28211
Phone (704) 365-6730

2826 Randolph Rd
Ste 100
Charlotte, NC 28211

2826 Randolph Rd
Charlotte, NC 28211
Phone (704) 358-0308

4741 Randolph Rd
Ste 100200
Charlotte, NC 28211
Phone (704) 365-6730

19485 Old Jetton Rd
Ste 210
Cornelius, NC 28031
Phone (704) 316-1830

16525 Holly Crest Ln
Ste 150
Huntersville, NC 28078
Phone (704) 384-1725

6909 Prosperity Church Rd
Huntersville, NC 28078
Phone (704) 316-1830

130 Plantation Ridge Dr
Ste 100
Mooresville, NC 28117
Phone (704) 316-1635

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1568448173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-358-0308",
            "fax_number": "704-358-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19485 OLD JETTON RD STE 210",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316592",
            "telephone_number": "704-316-1830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2826 Randolph Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111019",
            "country_code": "US",
            "telephone_number": "704-358-0308",
            "fax_number": "704-358-0039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "SCOTT",
        "middle_name": "BRANDON",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swebster78572@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2826 Randolph Rd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282111019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

Verify at the official NPI Registry.