Scott A Hathaway, D.O.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

36307 Issued in WI

Practice address

309 N Bartlett St
Shawano, WI 54166-2127

Phone

(715) 526-2111

Fax

(715) 526-9174

NPI assigned

Sep 27, 2006

Last updated

Nov 2, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1669563763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 N BARTLETT ST",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662127",
            "telephone_number": "715-526-2111",
            "fax_number": "715-526-9174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 N BARTLETT ST",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662127",
            "telephone_number": "715-526-2111",
            "fax_number": "715-526-9174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHAWAY",
        "first_name": "SCOTT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WI",
            "license": "36307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30064500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marissa Leigh Hakala, PHARMD
• William D. Hampton, D.O.
• Rajeshwar Hanmiah, M.D.
• Elizabeth Harbison, MD
• Shannon Marie Hartman
• Mark E. Heideman, D.D.S.
• Thomas F. Henke, D.D.S.
• Mark Scott Herbert
• Jennifer Herm, P.T.A.
• Jeffrey Herman, MS

• Emergency Medical Services (Emergency Medicine) Physician in Shawano, WI
• Providers in Shawano, WI by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.