Individual provider Active NPI

James George Scanlan, M.D.

  • Interventional Cardiology Physician
  • Raleigh, NC
National Provider Identifier
1962499087
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
24289 Issued in NC
Practice address
4201 Lake Boone TRL
Suite 104
Raleigh, NC 27607-7512
Phone
(919) 881-0160
Fax
(919) 881-0887
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 024289 NC
Interventional Cardiology Physician 207RI0011X 24289 NC Primary

Addresses

Primary practice location

4201 Lake Boone TRL
Suite 104
Raleigh, NC 27607-7512

Mailing address

4201 Lake Boone TRL Ste 104
Raleigh, NC 27607-7511
Phone (919) 881-0160

Other identifiers 2

IdentifierTypeStateIssuer
060000080OtherNCRAILROAD MEDICARE
8974730MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jscanlan78377@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20100211000245 NC Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 2163406513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Northwestern University Feinberg Medical School, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

4201 Lake Boone TRL
Suite 104
Raleigh, NC 27607-7511
Phone (919) 881-0160

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024289NCMDCardiovascular Disease Physician
24289NCMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina MG, LLC Cardiovascular Disease CurrentSince Jun 1, 2025 Accepting new patients
Rex Hospital Inc Cardiovascular Disease Past Accepting new patients
Rex Hospital, Inc. Past Accepting new patients

Locations

4201 Lake Boone Trl
Ste 104
Raleigh, NC 27607
Phone (919) 881-0160

4207 Lake Boone Trl
Ste 200
Raleigh, NC 27607
Phone (919) 782-3456

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

Interoperability endpoints

  • Direct secure messaging: jscanlan78377@direct.unc.nchie.net

Organizations & group practices 4

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 1

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1962499087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL STE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077511",
            "telephone_number": "919-881-0160",
            "fax_number": "919-881-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL",
            "address_2": "SUITE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077512",
            "telephone_number": "919-881-0160",
            "fax_number": "919-881-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLAN",
        "first_name": "JAMES",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "024289",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "24289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060000080",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8974730",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jscanlan78377@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4201 Lake Boone Trl",
            "address_2": "Suite 104",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276077512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.