Individual provider Active NPI

Scott William McLain, MD

  • Internal Medicine Physician
  • Bloomington, IL
National Provider Identifier
1669463436
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036104057 Issued in IL
Practice address
1701 E College Ave
Bloomington, IL 61704
Phone
(309) 662-5361
Fax
(309) 663-5742
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2007006527 MO
Internal Medicine Physician 207R00000X 036104057 IL Primary

Addresses

Primary practice location

1701 E College Ave
Bloomington, IL 61704

Mailing address

5850 6TH Street Frontage Rd E
Springfield, IL 62703-5162
Phone (217) 529-5046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20180828001814 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3779523907

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036104057ILMDInternal Medicine Physician
2007006527MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Internal Medicine PastSince Apr 28, 2024 Accepting new patients
Mercy Clinic East Communities Internal Medicine Past Accepting new patients
Vpa PC Internal Medicine Past Accepting new patients
Capitol Healthcare Medical Associates, LLC Internal Medicine Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1669463436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 6TH STREET FRONTAGE RD E",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035162",
            "telephone_number": "217-529-5046",
            "fax_number": "217-529-6154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E COLLEGE AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61704",
            "telephone_number": "309-662-5361",
            "fax_number": "309-663-5742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAIN",
        "first_name": "SCOTT",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2007006527",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036104057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.