Individual provider Active NPI

Lauren Scott, ATC

  • Athletic Trainer
  • Severna Park, MD
National Provider Identifier
1861990004
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2601001788 Issued in MI
Practice address
770 Ritchie Hwy # 21
Severna Park, MD 21146-4149
Phone
(313) 749-8239
NPI assigned
Jan 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2601001788 MI Primary

Addresses

Primary practice location

770 Ritchie Hwy # 21
Severna Park, MD 21146-4149

Mailing address

770 Ritchie Hwy # 21
Severna Park, MD 21146-4149

Other identifiers 2

IdentifierTypeStateIssuer
2000026163OtherBOARD OF CERTIFICATION
2601001788OtherMISTATE OF MICHIGAN ATHLETIC TRAINING LICENSE

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2601001788MIMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Valley State University Past Accepting new patients
Grand Valley State University Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1861990004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 RITCHIE HWY # 21",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211464149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 RITCHIE HWY # 21",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211464149",
            "telephone_number": "313-749-8239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "LAUREN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-23",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601001788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF CERTIFICATION",
            "identifier": "2000026163",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN ATHLETIC TRAINING LICENSE",
            "identifier": "2601001788",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.