Active NPI
Roger D Scow Jr., MD
- Obstetrics & Gynecology Physician
- Magnolia, AR
National Provider Identifier
1609862838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- E5489
- Practice address
- 712 W Main St
Magnolia, AR 71753-3412 - Phone
- (796) 524-6304
- NPI assigned
- Sep 22, 2005
- Last updated
- Dec 27, 2022
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | E5489 | AR | Primary |
Addresses
Primary practice location
712 W Main St
Magnolia, AR 71753-3412
Mailing address
712 W Main St
Magnolia, AR 71753-3412
Phone (796) 524-6304
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 167236001 | Medicaid | AR | |
| 200125940A | Medicaid | OK | |
| 048061802 | Medicaid | TX |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E5489 | AR | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fort Smith Hma PBC Management, LLC | Past | Accepting new patients | |
| Fort Smith Hma, LLC | Past | Accepting new patients | |
| Sparks Regional Medical Center | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Fort Smith, AR
- NPI 1477888907
-
dba Sparks Regional Medical Center
- General Acute Care Hospital
- Fort Smith, AR
- NPI 1578555736
-
- Skilled Nursing Facility
- Fort Smith, AR
- NPI 1992916308
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672099200000",
"number": "1609862838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "712 W MAIN ST",
"city": "MAGNOLIA",
"state": "AR",
"postal_code": "717533412",
"telephone_number": "796-524-6304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 W MAIN ST",
"city": "MAGNOLIA",
"state": "AR",
"postal_code": "717533412",
"telephone_number": "796-524-6304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOW",
"first_name": "ROGER",
"middle_name": "D",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-22",
"last_updated": "2022-12-27",
"certification_date": "2022-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "AR",
"license": "E5489",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "167236001",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200125940A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "048061802",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Magnolia, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.