Individual provider Active NPI

Mary Ann Scott, PHD

  • Clinical Neuropsychologist
  • Lowell, AR
National Provider Identifier
1659461218
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
96-27P Issued in AR
Practice address
519 Latham Dr
Lowell, AR 72745-8360
Phone
(479) 750-0125
Fax
(479) 750-0323
NPI assigned
Oct 13, 2006
Last updated
Mar 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 96-27P AR Primary

Addresses

Primary practice location

519 Latham Dr
Lowell, AR 72745-8360

Mailing address

519 Latham Dr
Lowell, AR 72745-8360
Phone (479) 750-0125

Other identifiers 1

IdentifierTypeStateIssuer
118426726MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20110221000419 AR Practitioner - PsychiatryPractitioner - Other (Physician) 8820279110 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
96-27PARMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Feb 1, 2011 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Feb 1, 2011 Accepting new patients
University of Arkansas for Medical Sciences Past Accepting new patients

Locations

1301 Wolfe St
Little Rock, AR 72202
Phone (501) 364-1830

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
Ste 653
Little Rock, AR 72202

4301 W Markham St
Ste 783
Little Rock, AR 72205
Phone (501) 603-1278

519 Latham Dr
Lowell, AR 72745
Phone (479) 750-0125

507 W Monroe Ave
Lowell, AR 72745
Phone (479) 334-7030

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1659461218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 LATHAM DR",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727458360",
            "telephone_number": "479-750-0125",
            "fax_number": "479-750-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 LATHAM DR",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727458360",
            "telephone_number": "479-750-0125",
            "fax_number": "479-750-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "MARY ANN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AR",
            "license": "96-27P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118426726",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, AR

Sources for this page

Verify at the official NPI Registry.