Beth Scoggan Costolnick, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1094738 Issued in GA

Practice address

550 Professional Dr
Macon, GA 31201-1411

Phone

(478) 741-3007

Fax

(478) 755-1547

NPI assigned

Sep 14, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Beth Anne Scoggan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1740598648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PROFESSIONAL DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011411",
            "telephone_number": "478-741-3007",
            "fax_number": "478-755-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PROFESSIONAL DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011411",
            "telephone_number": "478-741-3007",
            "fax_number": "478-755-1547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTOLNICK",
        "first_name": "BETH",
        "middle_name": "SCOGGAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "1094738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXPAYER  IDENTIFICATION NUMBER",
            "identifier": "582409645",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "SCOGGAN",
            "middle_name": "ANNE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caitlin Michele Corley, RN, CPNP
• Cornerstone Caregiving East LLC
• Cornerstone Women's Health, P.C.
• Alejandro J. Correa, MD
• Nancy Michelle Corzine, PHARMD
• Gabrielle Christina Cotter, NP-C
• Amauri Cotton
• Amia Cotton, B.S., RBT
• Danielle Lamneicsa Cotton, CNA
• Leshannon Cotton

• Medical Physician Assistant in Macon, GA
• Providers in Macon, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.