Individual provider Active NPI

Dacon Scott, PA-C

  • Physician Assistant
  • Quincy, IL
National Provider Identifier
1699395020
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.007915 Issued in IL
Practice address
4800 Maine St
Quincy, IL 62305-5875
Phone
(217) 214-0444
Fax
(217) 277-3960
NPI assigned
Apr 27, 2020
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10077 GA
Physician Assistant 363A00000X 085.007915 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

4800 Maine St
Quincy, IL 62305-5875

Mailing address

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

Other practice location 1

606 N Allen St
Robinson, IL 62454-1102
Phone (217) 506-0471

Other practice location 2

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

Other practice location 3

640 W Washington St
Pittsfield, IL 62363-1350
Phone (217) 285-2113

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210624001326 IL Practitioner - Physician Assistant 6002217338 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

4800 Maine St
Quincy, IL 62305-5875
Phone (217) 224-6423

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10077GAMDPhysician Assistant
085.007915ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Blessing Hospital CurrentSince Mar 1, 2023 Accepting new patients
West Central Pathology Specialists, S.C. Current Accepting new patients
Carle Bromenn Medical Center CurrentSince Dec 1, 2023 Accepting new patients
Blessing Hospital CurrentSince Mar 1, 2023 Accepting new patients
Quincy Clinical Laboratory Services SC Current Accepting new patients
Blessing Hospital CurrentSince Dec 1, 2024 Accepting new patients
Carle Bromenn Medical Center CurrentSince Dec 1, 2023 Accepting new patients
Blessingcare Corporation Current Accepting new patients
Blessingcare Corporation CurrentSince Mar 17, 2021 Accepting new patients
Blessingcare Corporation Past Accepting new patients
Blessing Corporate Services Inc Past Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

1300 Franklin Ave
Ste 100
Normal, IL 61761
Phone (309) 268-3503

640 W Washington St
Pittsfield, IL 62363
Phone (217) 285-2113

1005 Broadway St
Quincy, IL 62301

4800 Maine St
Quincy, IL 62305
Phone (217) 214-0444

Interoperability endpoints

  • Direct secure messaging: dscottpa398899@carlehiedirect.net
  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1699395020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623055875",
            "telephone_number": "217-214-0444",
            "fax_number": "217-277-3960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "606 N Allen St",
            "address_purpose": "LOCATION",
            "city": "Robinson",
            "state": "IL",
            "postal_code": "624541102",
            "country_code": "US",
            "telephone_number": "217-506-0471",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1005 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623012834",
            "country_code": "US",
            "telephone_number": "217-223-8400",
            "fax_number": "217-277-3960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "640 W Washington St",
            "address_purpose": "LOCATION",
            "city": "Pittsfield",
            "state": "IL",
            "postal_code": "623631350",
            "country_code": "US",
            "telephone_number": "217-285-2113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "DACON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-27",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10077",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.007915",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.