Kevin C Scott, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

4301085671 Issued in MI

Practice address

325 E H St
Iron Mountain, MI 49801-4760

Phone

(067) 774-3300

NPI assigned

Oct 23, 2006

Last updated

May 13, 2020By 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 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1871676163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 E H ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014760",
            "telephone_number": "906-774-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E H ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014760",
            "telephone_number": "067-774-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "KEVIN",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301085671",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301085671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4763830",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "34-0-22-1066-2",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4940774",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Delaine Schroeder
• Julia Beth Schuetter
• Jaime Danielle Schultz, R.D.
• Jessica Schulze, PT, DPT
• Peter Emil Schwager, RD
• Susan Scullon
• Christopher G Selden, DDS
• John F Selden, MD
• Clayton Shaker, M.D.
• Dale Roger Shampo, MD

• Urology Physician in Iron Mountain, MI
• Providers in Iron Mountain, MI by specialty
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.