Individual provider Active NPI

Stacy Denise Scott-McKinney, M.D.

  • Pediatrics Physician
  • Laurel, MD
National Provider Identifier
1609816768
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0041884 Issued in MD
Practice address
13900 Laurel Lakes Avenue
Suite 240
Laurel, MD 20707-5046
Phone
(301) 498-1900
Fax
(301) 497-9885
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0041884 MD Primary

Addresses

Primary practice location

13900 Laurel Lakes Avenue
Suite 240
Laurel, MD 20707-5046

Mailing address

13900 Laurel Lakes Avenue
Suite 240
Laurel, MD 20707-5046
Phone (301) 498-1900

Other identifiers 1

IdentifierTypeStateIssuer
199411500MedicaidMD

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0041884MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Laurel Lakes Primary Care, LLC Pediatrics Past Accepting new patients
Children'S Pediatricians & Associates, LLC Pediatrics Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1609816768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13900 LAUREL LAKES AVENUE",
            "address_2": "SUITE 240",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075046",
            "telephone_number": "301-498-1900",
            "fax_number": "301-497-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13900 LAUREL LAKES AVENUE",
            "address_2": "SUITE 240",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075046",
            "telephone_number": "301-498-1900",
            "fax_number": "301-497-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT-MCKINNEY",
        "first_name": "STACY",
        "middle_name": "DENISE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0041884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199411500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.