Active NPI
Scott Gordon Ross
- Home Modifications Contractor
- Saint Johns, FL
National Provider Identifier
1619304060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- License
- CRC-057575
- Practice address
- 2121 Forest Hollow Way
Saint Johns, FL 32259-2949 - Phone
- (904) 342-6844
- NPI assigned
- Oct 1, 2013
- 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 |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | CRC-057575 | FL | Primary |
Addresses
Primary practice location
2121 Forest Hollow Way
Saint Johns, FL 32259-2949
Mailing address
2121 Forest Hollow Way
Saint Johns, FL 32259-2949
Phone (904) 342-6844
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 |
|---|---|---|---|
| CRC-057575 | FL | MD | Home Modifications Contractor |
Organizations & group practices 1
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.
-
- Home Modifications Contractor
- Jacksonville, FL
- NPI 1487027181
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380585600000",
"number": "1619304060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2121 FOREST HOLLOW WAY",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322592949",
"telephone_number": "904-342-6844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 FOREST HOLLOW WAY",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322592949",
"telephone_number": "904-342-6844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "SCOTT",
"middle_name": "GORDON",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-10-01",
"last_updated": "2013-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": "FL",
"license": "CRC-057575",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Johns, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.