Scott Beals DO PA

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

OS7143 Issued in FL

Legal business name

SCOTT BEALS DO PA

Practice address

4566 E Highway 20
Suite 101
Niceville, FL 32578-8838

Phone

(850) 897-7546

Fax

(850) 897-7547

NPI assigned

May 10, 2007

Organization subpart

No

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

Authorized official

Name

Scott L. Beals, D.O.NPI 1912000464

Title

Physician

Phone

(850) 897-7546

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dermatology Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott L Beals, D.O.

  • Dermatopathology Physician
  • Niceville, FL
  • NPI 1912000464
  Medicare reassignment Authorized official
• Jordan Miller, PA-C

  • Physician Assistant
  • Lawrenceville, GA
  • NPI 1194201954

  FL

  Medicare reassignment
• Bridget Casey

  • Nurse Practitioner
  • Gulf Breeze, FL
  • NPI 1699344127
  NPD (past)
• Catherine Mary O'Connell, ARNP

  • Pediatric Nurse Practitioner
  • Niceville, FL
  • NPI 1386711885
  NPD (past)

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1699989301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4566 E HIGHWAY 20",
            "address_2": "SUITE 101",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788838",
            "telephone_number": "850-897-7546",
            "fax_number": "850-897-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4566 E HIGHWAY 20",
            "address_2": "SUITE 101",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788838",
            "telephone_number": "850-897-7546",
            "fax_number": "850-897-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT BEALS DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "BEALS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "850-897-7546",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "OS7143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICARE  PTAN INDIVIDUAL #",
            "identifier": "13586Y",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266706100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICARE PTAN GROUP #",
            "identifier": "K4270",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• School Board of Okaloosa County FL
• Gabriela R Schoolcraft
• Mark Edward Schroeder, M.D.
• Brian Schuessler, D.C.
• Elise Nicole Schuyten, OTR/L
• Scott Eye & Vision LLC
• Cory Marcus Scott, P.T.
• Seabreeze Endodontics, PA
• Erika Steele Seagle, CPNP-PC
• Second Optometric Care of Florida PA

• Procedural Dermatology Physician in Niceville, FL
• Providers in Niceville, FL by specialty
• Procedural Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.