Scott K. Withers, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA193 Issued in ME

Practice address

246 Camp Rd
Cooper, ME 04657-3221

Phone

(207) 454-7693

Fax

(207) 454-0929

NPI assigned

Jul 1, 2006

Last updated

Oct 16, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Physician Assistant

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1689603813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 CAMP RD",
            "city": "COOPER",
            "state": "ME",
            "postal_code": "04657",
            "telephone_number": "207-454-7693",
            "fax_number": "207-454-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 CAMP RD",
            "city": "COOPER",
            "state": "ME",
            "postal_code": "046573221",
            "telephone_number": "207-454-7693",
            "fax_number": "207-454-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERS",
        "first_name": "SCOTT",
        "middle_name": "K.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S2017",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.