Scott Russell Bishop, M.D.
Individual provider Active NPI Family Medicine Physician · Syracuse, UT
NPI 1962493486 · NPPES record last updated Aug 29, 2017
Key facts
- NPI
- 1962493486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 22441 (NE)
- Practice address
- 2038 W 1900 S
Syracuse, UT 84075-9320 - Phone
- (801) 773-4840
- Fax
- (801) 926-1032
- NPI assigned
- Nov 3, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- 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 Clinic
Practice addresses (Care Compare)
2038 W 1900
Syracuse, UT 84075-9320
Phone (801) 773-4840
Hospital & facility affiliations
- Symbii Home Health
- Holy Cross Hospital-Davis
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 22 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080820000078 | UT | Practitioner - Family Practice | 4587739982 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22441 | NE | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tanner Memorial Clinic | Current |
Accepting new patients | |
| Tanner Memorial Clinic | Current | Accepting new patients | |
| Tanner Memorial Clinic | Family Medicine | Current |
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
- scott.bishop.p1@direct.tannerclinic.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 22441 | NE | Yes |
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
Other providers in Syracuse, UT
- Ryan Toone Barlow
- Marc Nathan Barney
- BCF Group LLC
- BCL Medical, LLC
- Cynthia Beene
- Rylee Blackburn
- Jeanna Bokinskie
- Christopher Bowler
- Jennifer A Brady
- Daniel C. Brandley
All providers in Syracuse, UT · Family Medicine Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.