Scott O. Davis, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD00042529 Issued in WA

Practice address

1525 W Court St
Pasco, WA 99301-4070

Phone

(509) 542-9285

Fax

(509) 545-0699

NPI assigned

Jun 1, 2007

Last updated

Jan 28, 2014By the provider in NPPES

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 9, 2016 through Feb 9, 2028

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Columbia River Medical Center PLLC

  • Family Medicine Physician
  • Pasco, WA
  • NPI 1902939945
  NPD (past)

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1790987881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 W COURT ST",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993014070",
            "telephone_number": "509-547-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 W COURT ST",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993014070",
            "telephone_number": "509-542-9285",
            "fax_number": "509-545-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SCOTT",
        "middle_name": "O.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00042529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD2801",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alina Roxana Davidson, D.D.S.
• Bernedette Davis, MSW, LSWAIC
• Kacey Davis, LMP
• Nathan Victor Davis, MSW, LSWAIC, SUDPT
• Ronald Eugene Davis, M.D.
• Stefanie Marie Davis, R.D.
• Michelle Dawson, LMP
• Angela Lynn De la Rosa
• Paolo Antonio De Belen De Vera, MD
• Brian Scott Dean, SWAA

• Pediatrics Physician in Pasco, WA
• Providers in Pasco, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.