NPIMap

Individual provider Active NPI

Tina Scoggins, DO

  • Family Medicine Physician
  • Ashton, ID
National Provider Identifier
1689037129
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-1294 Issued in ID
Practice address
23 S 8TH St
Ashton, ID 83420-5211
Phone
(208) 652-3396
Fax
(208) 652-7924
NPI assigned
Apr 1, 2016
Last updated
Oct 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X O-1294 ID Primary

Addresses

Primary practice location

23 S 8TH St
Ashton, ID 83420-5211

Mailing address

23 S 8TH St
Ashton, ID 83420-5211
Phone (208) 652-3396

Other practice location 1

350 Hospital Way Ste 101
Somerset, KY 42503-2872
Phone (606) 451-5092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191030002281 ID Practitioner - Osteopathic Manipulative Medicine 3375882988 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashton Memorial IncGroup PAC ID 7719898873, 4 clinicians

Practice addresses (Care Compare)

23 S 8TH St
Ashton, ID 83420-5211
Phone (208) 652-3396

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O-1294IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ashton Memorial, Inc. CurrentSince Jun 3, 2020 Accepting new patients
Community Care Pocatello PLLC Current Accepting new patients
Community Care West Side LLC Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Ashton Memorial, Inc. CurrentSince Jun 3, 2020 Accepting new patients
CC Pocatello LLC Family Medicine CurrentSince Sep 9, 2020 Accepting new patients
Mountain View Hospital LLC CurrentSince Sep 1, 2019 Accepting new patients
Ashton Memorial, Inc. Past Accepting new patients

Locations

1273 E 17th St
Idaho Falls, ID 83404
Phone (208) 523-0787

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

2725 Channing Way
Idaho Falls, ID 83404
Phone (208) 525-8448

765 S Utah Ave
Idaho Falls, ID 83402
Phone (208) 525-2600

1595 Yellowstone Ave
Pocatello, ID 83201
Phone (208) 233-0032

167 E 1st S
Rigby, ID 83442
Phone (208) 745-8747

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1689037129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 S 8TH ST",
            "city": "ASHTON",
            "state": "ID",
            "postal_code": "834205211",
            "telephone_number": "208-652-3396",
            "fax_number": "208-652-7924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 S 8TH ST",
            "city": "ASHTON",
            "state": "ID",
            "postal_code": "834205211",
            "telephone_number": "208-652-3396",
            "fax_number": "208-652-7924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Hospital Way Ste 101",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "KY",
            "postal_code": "425032872",
            "country_code": "US",
            "telephone_number": "606-451-5092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOGGINS",
        "first_name": "TINA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-01",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-1294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashton, ID

Sources for this page

Verify at the official NPI Registry.