Forrest Scott Chilcott Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A19964 Issued in CA

Practice address

1144 Sonoma Ave Ste 104
Santa Rosa, CA 95405-4812

Phone

(707) 542-1933

Fax

(707) 542-6227

NPI assigned

Jul 2, 2006

Last updated

Nov 1, 2011By 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

Other names 1

• F Scott Chilcott Jr. Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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.

• Santa Rosa Trauma Physicians Medical Group

  • Trauma Surgery Physician
  • Santa Rosa, CA
  • NPI 1184673162

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1841229689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 SONOMA AVE STE 104",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054812",
            "telephone_number": "707-542-1933",
            "fax_number": "707-542-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 SONOMA AVE STE 104",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054812",
            "telephone_number": "707-542-1933",
            "fax_number": "707-542-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILCOTT",
        "first_name": "FORREST",
        "middle_name": "SCOTT",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A19964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A199640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "F",
            "last_name": "CHILCOTT",
            "middle_name": "SCOTT",
            "suffix": "JR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elisabeth Chicoine
• Deborah Lynn Chiddix, PSY.D.
• Elena Chieffo
• Deborah Ann Chigazola, RDHAP, MS
• Chilcott MD Inc (Changing Health)
• Marisha E. Chilcott, M.D.
• Ullrike Johanna Childs
• Jerome Hsi-Cheng Chin, M.D. PH.D.
• Warren Bruce Chin, MD
• Regina L. Chinn, LCSW

• Family Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.