NPIMap

Organization Active NPI

Phoenix Emergency Services of Madison LLC

  • Emergency Medicine Physician
  • Madison, IN
National Provider Identifier
1881683548
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
PHOENIX EMERGENCY SERVICES OF MADISON LLC
Practice address
1 Kings Daughters Dr
Phoenix Emergency Services of Madison
Madison, IN 47250-3300
Phone
(812) 265-5211
NPI assigned
Oct 17, 2005
Last updated
Apr 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Authorized official

Name
Dr. Steven M. Scott, MD
Title
Owner
Phone
(877) 751-1157

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary
Nurse Practitioner 363L00000X NU

Addresses

Primary practice location

1 Kings Daughters Dr
Phoenix Emergency Services of Madison
Madison, IN 47250-3300

Mailing address

2828 Croasdaile Dr
Phoenix Emergency Services of Madison
Durham, NC 27705-2505
Phone (877) 751-1157

Other identifiers 6

IdentifierTypeStateIssuer
2640517000OtherKYPASSPORT HEALTHPLAN ADVANTAGE HMO MEDICARE
00000380234OtherINBLUE CROSS BLUE SHIELD OF IN
200540070 AMedicaidIN
65944647MedicaidKY
78904984MedicaidKY
50009161OtherKYPASSPORT HEALTH PLAN

National Provider Directory

National Provider Directory

Locations

2828 Croasdaile Dr
Durham, NC 27705
Phone (866) 272-3030

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1881683548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 CROASDAILE DR",
            "address_2": "PHOENIX EMERGENCY SERVICES OF MADISON",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277052505",
            "telephone_number": "877-751-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KINGS DAUGHTERS DR",
            "address_2": "PHOENIX EMERGENCY SERVICES OF MADISON",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472503300",
            "telephone_number": "812-265-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX EMERGENCY SERVICES OF MADISON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "877-751-1157",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTHPLAN ADVANTAGE HMO MEDICARE",
            "identifier": "2640517000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF IN",
            "identifier": "00000380234",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200540070 A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65944647",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78904984",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "50009161",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.