Individual provider Active NPI

Scott Russell Bishop, M.D.

  • Family Medicine Physician
  • Syracuse, UT
National Provider Identifier
1962493486
Registry record updated Aug 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22441 Issued in NE
Practice address
2038 W 1900 S
Syracuse, UT 84075-9320
Phone
(801) 773-4840
Fax
(801) 926-1032
NPI assigned
Nov 3, 2005
Last updated
Aug 29, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22441 NE Primary

Addresses

Primary practice location

2038 W 1900 S
Syracuse, UT 84075-9320

Mailing address

PO Box 337
Layton, UT 84041-0337
Phone (801) 773-4840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080820000078 UT Practitioner - Family Practice 4587739982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Uniformed Services Uhs Fe Hebert School of Med, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians

Practice addresses (Care Compare)

2038 W 1900
Syracuse, UT 84075-9320
Phone (801) 773-4840

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions22
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22441NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Memorial Clinic Family Medicine CurrentSince Jul 19, 2009 Accepting new patients
Tanner Memorial Clinic Current Accepting new patients
Tanner Memorial Clinic CurrentSince Jul 19, 2009 Accepting new patients

Locations

380 N 400 W
Kaysville, UT 84037
Phone (801) 547-9500

425 S 100 W
Layton, UT 84041
Phone (801) 682-8708

2038 W 1900 S
Syracuse, UT 84075
Phone (801) 773-7899

Interoperability endpoints

  • Direct secure messaging: scott.bishop.p1@direct.tannerclinic.nextgenshare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503964800000",
    "number": "1962493486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840410337",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2038 W 1900 S",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "840759320",
            "telephone_number": "801-773-4840",
            "fax_number": "801-926-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "SCOTT",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2017-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "22441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, UT

Sources for this page

Verify at the official NPI Registry.