Active NPI
Domonic Teheran Scott
- Driver
- Suffolk, VA
National Provider Identifier
1598284283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- T60356518
- Practice address
- 102 Brewer Ave
Suffolk, VA 23434 - Phone
- (757) 288-6833
- Fax
- (757) 272-0626
- NPI assigned
- Sep 13, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Driver | 172A00000X | T60356518 | VA | Primary |
Addresses
Primary practice location
102 Brewer Ave
Suffolk, VA 23434
Mailing address
102 Brewer Ave
Suffolk, VA 23434-5602
Phone (757) 602-0544
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 |
|---|---|---|---|
| T60356518 | VA | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505260800000",
"number": "1598284283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 BREWER AVE",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234345602",
"telephone_number": "757-602-0544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 BREWER AVE",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "23434",
"telephone_number": "757-288-6833",
"fax_number": "757-272-0626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "DOMONIC",
"middle_name": "TEHERAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-13",
"last_updated": "2017-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "VA",
"license": "T60356518",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suffolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.