Randall Scott, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS11177 Issued in FL

Practice address

3189 Highway 17
Green Cove Springs, FL 32043-9371

Phone

(904) 621-0643

Fax

(904) 621-0644

NPI assigned

Jun 23, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Family Practice

Education

Lake Erie College of Osteopathic Medicine, Erie, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Wellness Center GCS IncGroup PAC ID 3375885890, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Concierge Home Care Home health agency, Orange Park, FL, CCN 109771
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JHCJBD

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.

• Family Wellness Center GCS Inc

  • Family Medicine Physician
  • Green Cove Springs, FL
  • NPI 1861954653
  Medicare reassignment Care Compare group NPD Authorized official
• Elite Imaging LLC

  • Diagnostic Radiology Physician
  • Plantation, FL
  • NPI 1376819888
  Medicare reassignment NPD
• Elite Imaging LLC

  • Diagnostic Radiology Physician
  • Orange Park, FL
  • NPI 1346516853
  NPD
• Elite Imaging, LLC

  • Diagnostic Radiology Physician
  • Aventura, FL
  • NPI 1942208319
  NPD
• Physicians Group Services PA

  • Family Medicine Physician
  • Orange Park, FL
  • NPI 1861440810
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation
• The Roses' Home Healthcare, LLC

  • Home Health Agency
  • Orange Park, FL
  • NPI 1629262449
  Care Compare affiliation

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1619138658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3189 HIGHWAY 17",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320439371",
            "telephone_number": "904-621-0247",
            "fax_number": "904-339-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3189 HIGHWAY 17",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320439371",
            "telephone_number": "904-621-0643",
            "fax_number": "904-621-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS 11177",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS11177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tasha Lynn Sanfiel, PTA
• Carlos Damian Santiago, PA-C, DMO
• School Board of Clay County
• School Board of Clay County
• School Board of Clay County
• Jana Renee Shaddix Diaz, PT
• Shahriar a Nabizadeh MD PA
• Smiling Creations, PA
• Kayla Smith, FNP-BC
• Lawrence Matthew Smith, PHARMD

• Family Medicine Physician in Green Cove Springs, FL
• Providers in Green Cove Springs, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.