Active NPI
Fred Randolph Scott III
- Professional Counselor
- Suffolk, VA
National Provider Identifier
1679272090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701012670
- Practice address
- 208 Republic LN
Suffolk, VA 23434-1005 - Phone
- (757) 269-1400
- NPI assigned
- Feb 24, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0704013358 | VA | |
| Professional Counselor | 101YP2500X | 0701012670 | VA | Primary |
Addresses
Primary practice location
208 Republic LN
Suffolk, VA 23434-1005
Mailing address
PO Box 1492
Suffolk, VA 23439-1492
Phone (757) 269-1400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
425 W Washington St
Suite 4
Suffolk, VA 23434-5320
Phone (757) 338-1421
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0704013358 | VA | MD | Professional Counselor |
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 and National Provider Directory roles.
-
- Mental Health Counselor
- Suffolk, VA
- NPI 1043999162
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699401600000",
"number": "1679272090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1492",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234391492",
"telephone_number": "757-269-1400",
"fax_number": "757-809-3423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 REPUBLIC LN",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234341005",
"telephone_number": "757-269-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "FRED",
"middle_name": "RANDOLPH",
"name_prefix": "Dr.",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-24",
"last_updated": "2023-11-08",
"certification_date": "2023-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0704013358",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701012670",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suffolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.