Active NPI
Mark David Scott, M.D.
- Family Medicine Physician
- Decatur, IL
National Provider Identifier
1598867707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036084016
- Practice address
- 1110 Arbor Dr
Suite D
Decatur, IL 62526-9285 - Phone
- (217) 875-9995
- Fax
- (217) 875-9998
- NPI assigned
- Sep 1, 2006
- Last updated
- Dec 9, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036084016 | IL | Primary |
Addresses
Primary practice location
1110 Arbor Dr
Suite D
Decatur, IL 62526-9285
Mailing address
1110 Arbor Dr
Suite D
Decatur, IL 62526-9285
Phone (217) 875-9995
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | markscott@siusm.allscriptsdirect.net |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Marys Hospital Decatur of the Hospital Sisters of the Third Order | Past | Accepting new patients | |
| Progressive Family Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Legal Medicine
- Decatur, IL
- NPI 1942425517
-
dba St Marys Hospital
- General Acute Care Hospital
- Decatur, IL
- NPI 1326041229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607472000000",
"number": "1598867707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 ARBOR DR",
"address_2": "SUITE D",
"city": "DECATUR",
"state": "IL",
"postal_code": "625269285",
"telephone_number": "217-875-9995",
"fax_number": "217-875-9998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 ARBOR DR",
"address_2": "SUITE D",
"city": "DECATUR",
"state": "IL",
"postal_code": "625269285",
"telephone_number": "217-875-9995",
"fax_number": "217-875-9998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "MARK",
"middle_name": "DAVID",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2020-12-09",
"certification_date": "2020-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036084016",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "markscott@siusm.allscriptsdirect.net",
"affiliation": "N",
"address_1": "1110 Arbor Dr",
"address_2": "Suite D",
"city": "Decatur",
"state": "IL",
"country_code": "US",
"postal_code": "625269285",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.