Gwendolyn Scott, DNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209.029180 Issued in IL

Practice address

612 N 11TH St
Quincy, IL 62301-2662

Phone

(217) 224-9484

Fax

(217) 224-7950

NPI assigned

Aug 24, 2016

Last updated

Jan 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, IL2 enrollments

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 2

Specialty

Nurse Practitioner

Education

University of Iowa, RJ & L Carver College of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Centers of Southeastern Iowa IncGroup PAC ID 4486562527, shared by 6 NPIs, 24 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.02 of 100Reported as group

Quality

75.68

Promoting interoperability

78

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gscott@fmchosp.gwaydirect.com
• Direct secure messaging: gscott20313@uihcdirect.org
• Direct secure messaging: gwendolynscott@siu.allscriptsdirect.net

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.

• Board of Trustees of Southern Illinois University

  dba Siu Center for Family Medicine

  • Primary Care Clinic/Center
  • Springfield, IL
  • NPI 1396097960
  Medicare reassignment NPD
• Transitions of Western Illinois Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Quincy, IL
  • NPI 1194784819
  Medicare reassignment NPD
• Community Health Centers of Southeastern Iowa Inc

  • Federally Qualified Health Center (FQHC)
  • West Burlington, IA
  • NPI 1255339750

  Nurse Practitioner

  Medicare reassignment NPD
• QV Urgent Care Ia PLLC

  dba QuickVisit Urgent Care

  • Urgent Care Clinic/Center
  • Mt Pleasant, IA
  • NPI 1407465917
  Medicare reassignment NPD
• Board of Trustees of Southern Illinois University

  dba SIU Center for Family Medicine - Care-A-Van

  • Federally Qualified Health Center (FQHC)
  • Carbondale, IL
  • NPI 1568210425
  NPD
• Siuphysicians & Surgeons, Inc.

  dba Siu Quincy Family Practice Center

  • Rural Health Clinic/Center
  • Quincy, IL
  • NPI 1609811520
  NPD
• Community Health Centers of Southeastern Iowa, Inc

  • Federally Qualified Health Center (FQHC)
  • West Burlington, IA
  • NPI 1144044637
  NPD
• Community Health Centers of Southeastern Iowa, Inc

  dba Tri-State Medical Group Inc

  • Federally Qualified Health Center (FQHC)
  • Keokuk, IA
  • NPI 1558340968
  NPD
• QV Urgent Care Ia PLLC

  dba Quickvisit Urgent Care

  • Rural Health Clinic/Center
  • Washington, IA
  • NPI 1235835950
  NPD

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1700331311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-8000",
            "fax_number": "844-470-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N 11TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012662",
            "telephone_number": "217-224-9484",
            "fax_number": "217-224-7950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2591 Holiday Rd",
            "address_purpose": "LOCATION",
            "city": "Coralville",
            "state": "IA",
            "postal_code": "522413039",
            "country_code": "US",
            "telephone_number": "319-467-7150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4409 Maine St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623055849",
            "country_code": "US",
            "telephone_number": "217-919-9139",
            "fax_number": "217-223-0413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "GWENDOLYN",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A119964",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A119964",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.029180",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.029180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Lee Schutte, D.P. T
• Irving L. Schwartz, M.D.
• Sarah Kathleen Scoggan, RN
• Elise Scoggin, D.O.
• Dacon Scott, PA-C
• John K Scott, MD
• Mackenzie Seals
• Nathan P. Seaman, D.O.
• Senior Care of Quincy LLC (Highpoint Residence Quincy)
• Serenity Sleep Solutions of Quincy, LLC

• Psychiatric/Mental Health Nurse Practitioner in Quincy, IL
• Providers in Quincy, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.

Verify at the official NPI Registry.