Payton Michael Scott, PT, DPT, LAT, AC

Individual provider Active NPI Physical Therapist · Gas City, IN

NPI 1740709559 · NPPES record last updated May 31, 2024

Key facts

NPI
1740709559
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
05015449A (IN)
Practice address
4900 Beaner Blvd
Gas City, IN 46933-9788
Phone
(765) 573-0725
NPI assigned
Sep 12, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
05015449AINMDPhysical Therapist
06005059AINMDPhysical Therapy Assistant
36002941AINMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06005059A IN
Athletic Trainer 2255A2300X 36002941A IN
Physical Therapist 225100000X 05015449A IN Yes

Addresses

Primary practice location

4900 Beaner Blvd
Gas City, IN 46933-9788

Mailing address

2865 E Eastridge Dr
Marion, IN 46953-5615

Other providers in Gas City, IN

All providers in Gas City, IN · Physical Therapist in Indiana

Sources for this page

Verify at the official NPI Registry.