Individual provider Active NPI

Rachel Elizabeth Hanis Scott, PA

  • Physician Assistant
  • Yreka, CA
National Provider Identifier
1902170954
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
22132 Issued in CA
Practice address
475 Bruce St Ste 700
Yreka, CA 96097-3473
Phone
(530) 842-9800
Fax
(530) 842-9054
NPI assigned
Mar 7, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 22132 CA Primary

Addresses

Primary practice location

475 Bruce St Ste 700
Yreka, CA 96097-3473

Mailing address

475 Bruce St Ste 700
Yreka, CA 96097-3473
Phone (530) 842-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120510000477 CA Practitioner - Physician Assistant 3870755747 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
22132CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Siskiyou Hospital, Inc. CurrentSince Jan 14, 2024 Accepting new patients
Dignity Health Past Accepting new patients
Dignity Health Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

408 Pine St
Mount Shasta, CA 96067
Phone (530) 926-3222

444 Bruce St
Yreka, CA 96097
Phone (530) 841-6256

475 Bruce St
Ste 700
Yreka, CA 96097
Phone (530) 842-7311

Organizations & group practices 5

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": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1902170954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 BRUCE ST STE 700",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973473",
            "telephone_number": "530-842-9800",
            "fax_number": "530-842-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BRUCE ST STE 700",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973473",
            "telephone_number": "530-842-9800",
            "fax_number": "530-842-9054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "RACHEL",
        "middle_name": "ELIZABETH HANIS",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yreka, CA

Sources for this page

Verify at the official NPI Registry.