NPIMap

Individual provider Active NPI

Derek S Scott I, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Newnan, GA
National Provider Identifier
1740377100
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
077308 Issued in GA
Practice address
2101 Newnan Crossing Blvd E
Newnan, GA 30265
Phone
(678) 552-6294
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301085359 MI
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 4301085359 MI
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 4301085359 MI
Physical Medicine & Rehabilitation Physician 208100000X 077308 GA Primary

Addresses

Primary practice location

2101 Newnan Crossing Blvd E
Newnan, GA 30265

Mailing address

980 Birmingham Rd Ste 501-403
Milton, GA 30004-4417
Phone (678) 552-6294

Other practice location 1

557 Riverstone Pkwy Ste 140
Canton, GA 30114-5223
Phone (678) 552-6294

Other practice location 2

1165 Sanders Rd
Cumming, GA 30041-5965
Phone (678) 552-6200

Other identifiers 2

IdentifierTypeStateIssuer
018888888MedicaidMI
43085359OtherMIBLUECROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20170407001187 GA Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 6507802022 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Meharry Medical College School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back to Life Medical Group, LLCGroup PAC ID 1658422456, 4 clinicians

Practice addresses (Care Compare)

2101 Newnan Crossing Blvd E
Newnan, GA 30265-2406
Phone (678) 552-6294

557 Riverstone Pkwy
Suite 140
Canton, GA 30114-5223
Phone (770) 345-4520

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.25 of 100Reported as individual
Quality
72.5
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301085359MIMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Medical Clinic L L C Physical Medicine & Rehabilitation CurrentSince Apr 28, 2019 Accepting new patients
Scott Medical Consultants Physical Medicine & Rehabilitation CurrentSince Feb 15, 2017 Accepting new patients
Back to Life Medical Group, LLC CurrentSince May 13, 2019 Accepting new patients
Piedmont Healthcare Encompass Health Rehab Hospital of Newnan, LLC Past Accepting new patients

Locations

197 14th St NW
Ste 300
Atlanta, GA 30318
Phone (404) 872-8837

557 Riverstone Pkwy
Canton, GA 30114
Phone (770) 345-4520

557 Riverstone Pkwy
Ste 140
Canton, GA 30114
Phone (678) 552-6294

1165 Sanders Rd
Cumming, GA 30041
Phone (210) 379-8553

3645 Marketplace Blvd
Ste 130692
East Point, GA 30344

980 Birmingham Rd
Ste 501403
Milton, GA 30004

2101 Newnan Crossing Blvd E
Newnan, GA 30265
Phone (678) 552-6200

Organizations & group practices 4

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 9

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1740377100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 BIRMINGHAM RD STE 501-403",
            "city": "MILTON",
            "state": "GA",
            "postal_code": "300044417",
            "telephone_number": "678-552-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 NEWNAN CROSSING BLVD E",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "30265",
            "telephone_number": "678-552-6294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "557 Riverstone Pkwy Ste 140",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301145223",
            "country_code": "US",
            "telephone_number": "678-552-6294",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1165 Sanders Rd",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300415965",
            "country_code": "US",
            "telephone_number": "678-552-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "DEREK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301085359",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MI",
            "license": "4301085359",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "MI",
            "license": "4301085359",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "077308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018888888",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "43085359",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.