Individual provider Active NPI

Brian Ernest Scott, D.O.

  • Emergency Medicine Physician
  • Lake Havasu City, AZ
National Provider Identifier
1578639969
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4244 Issued in AZ
Practice address
101 Civic Center LN
Lake Havasu City, AZ 86403-5607
Phone
(928) 855-8185
NPI assigned
Nov 28, 2006
Last updated
Feb 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4244 AZ Primary

Addresses

Primary practice location

101 Civic Center LN
Lake Havasu City, AZ 86403-5607

Mailing address

2491 Wood LN
Lake Havasu City, AZ 86406-8226
Phone (928) 855-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20050913001333 AZ Practitioner - Emergency Medicine 4789673062 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Emergency Medicine Specialists PC Emergency Medicine CurrentSince Jan 1, 2011 Accepting new patients
Central California Emergency Medicine Physicians Emergency Medicine Past Accepting new patients
Emergency Medical Services Group Emergency Medicine Past Accepting new patients

Locations

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1578639969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2491 WOOD LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864068226",
            "telephone_number": "928-855-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CIVIC CENTER LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035607",
            "telephone_number": "928-855-8185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "BRIAN",
        "middle_name": "ERNEST",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "4244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.