Individual provider Active NPI

Charles W Scowcroft, M.D.

  • Gastroenterology Physician
  • Paducah, KY
National Provider Identifier
1750336863
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
TP500 Issued in KY
Practice address
225 Medical Center Dr Ste 308
Paducah, KY 42003-7915
Phone
(270) 443-0777
Fax
(270) 443-0999
NPI assigned
May 24, 2006
Last updated
Jan 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 11819 SC
Gastroenterology Physician 207RG0100X TP500 KY Primary

Addresses

Primary practice location

225 Medical Center Dr Ste 308
Paducah, KY 42003-7915

Mailing address

225 Medical Center Dr Ste 308
Paducah, KY 42003-7915
Phone (270) 443-0777

Other identifiers 1

IdentifierTypeStateIssuer
118198MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170228002420 KY Practitioner - Gastroenterology 6709059488 Reassigns benefits to 2 organizations
I20171005001041 WA Practitioner - Gastroenterology 6709059488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Temple University School of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Kentucky Specialty Care LLCGroup PAC ID 1456777069, 144 clinicians

Practice addresses (Care Compare)

225 Medical Ctr Dr
Suite 308
Paducah, KY 42003-7915
Phone (270) 443-0777

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Sep 1, 2020 Accepting new patients
Sunnyside Community Hospital Association CurrentSince Sep 1, 2017 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group Inc Gastroenterology CurrentSince Oct 14, 2019 Accepting new patients
Sunnyside Community Hospital Association CurrentSince Sep 1, 2017 Accepting new patients
Sunnyside Community Hospital Association Current Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Sep 1, 2020 Accepting new patients
Pecora Medical, PC Past Accepting new patients
Charles W. Scowcroft PastSince Jul 1, 1984 Accepting new patients
Sunnyside Community Hospital Association Past Accepting new patients

Locations

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

1532 Lone Oak Rd
Ste 245
Paducah, KY 42003
Phone (270) 538-5537

1532 Lone Oak Rd
Ste 320
Paducah, KY 42003
Phone (270) 415-3830

225 Medical Center Dr
Ste 308
Paducah, KY 42003
Phone (270) 441-4760

208 N Euclid Rd
Grandview, WA 98930
Phone (509) 882-1855

2925 Allen Rd
Sunnyside, WA 98944
Phone (509) 837-4949

1005 W Walnut St
Ste 120
Yakima, WA 98902
Phone (509) 248-6080

110 S 9th Ave
Yakima, WA 98902
Phone (509) 575-5000

Interoperability endpoints

  • Direct secure messaging: charlesscowcroft@agallc.allscriptsdirect.net

Organizations & group practices 11

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 2

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1750336863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MEDICAL CENTER DR STE 308",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037915",
            "telephone_number": "270-443-0777",
            "fax_number": "270-443-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MEDICAL CENTER DR STE 308",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037915",
            "telephone_number": "270-443-0777",
            "fax_number": "270-443-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOWCROFT",
        "first_name": "CHARLES",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "11819",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "TP500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118198",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.