Kerwin Omarre Scott, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN26634 Issued in FL

Practice address

1395 Center Dr
Gainesville, FL 32610-3006

Phone

(352) 273-6700

NPI assigned

Feb 17, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Clermont Periodontics and Implant Center PLLC

  • Periodontics
  • Clermont, FL
  • NPI 1891530895
  NPD Authorized official
• Faculty Associates, Inc

  • Periodontics
  • Gainesville, FL
  • NPI 1275084204
  NPD (past)

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706400000000",
    "number": "1629661020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17522 PROMENADE DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347115894",
            "telephone_number": "731-313-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 CENTER DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103006",
            "telephone_number": "352-273-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "KERWIN",
        "middle_name": "OMARRE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-17",
        "last_updated": "2024-01-28",
        "certification_date": "2024-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN26634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DN26634",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kscott1@ufl.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "1395 Center Dr",
            "city": "Gainesville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "326103006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kscott1@ufl.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1395 Center Dr",
            "city": "Gainesville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "326103006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eric W Scott, MEDICAL DOCTOR
• Frances Scott, CMA
• Jack D Scott, MD
• Jemelia Scott
• Kaylin Laura Scott, MSN, AGACNP-BC
• Lorraine Scott, PA-C
• Melynie Scott
• Mya F Scott, CPT
• Suzanne J Scott, PH.D.
• Tiffany Scott, OT

• Periodontics in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2024; 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.