Individual provider Active NPI

Scotty Garland Dove, D.O.

  • Family Medicine Physician
  • Wytheville, VA
National Provider Identifier
1972622181
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102050091 Issued in VA
Practice address
245 Holston Rd
Suite B
Wytheville, VA 24382-4486
Phone
(276) 227-0460
Fax
(276) 227-0466
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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 0102050091 VA Primary

Addresses

Primary practice location

245 Holston Rd
Suite B
Wytheville, VA 24382-4486

Mailing address

245 Holston Rd
Suite B
Wytheville, VA 24382-4486
Phone (276) 227-0460

Other identifiers 1

IdentifierTypeStateIssuer
1972622181MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090317000382 VA Practitioner - Family Practice 8426115544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wythe County Physician Practices LLCGroup PAC ID 7517972789, 45 clinicians

Practice addresses (Care Compare)

245 Holston Rd
Suite B
Wytheville, VA 24382-4486
Phone (276) 227-0460

600 W Ridge Rd
Wytheville, VA 24382-1044
Phone (276) 228-0200

Hospital & facility affiliations

  • Wythe Circle Home Care Home health agency, Wytheville, VA, CCN 497094
  • Wythe County Community Hospital Hospital, Wytheville, VA, CCN 490111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102050091VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wythe County Physician Practices LLC Family Medicine CurrentSince Nov 1, 2008 Accepting new patients
Wythe County Physician Practices LLC Past Accepting new patients

Locations

791 Fort Chiswell Rd
Max Meadows, VA 24360
Phone (276) 637-6641

245 Holston Rd
Ste B
Wytheville, VA 24382
Phone (276) 227-0460

600 W Ridge Rd
Wytheville, VA 24382
Phone (276) 228-0200

360 Virginia Ave
Wytheville, VA 24382
Phone (276) 228-0080

Interoperability endpoints

  • Direct secure messaging: scotty.dove.1@10112.direct.athenahealth.com
  • Direct secure messaging: scotty.dove.1@19847.direct.athenahealth.com

Organizations & group practices 2

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.

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1972622181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 HOLSTON RD",
            "address_2": "SUITE B",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243824486",
            "telephone_number": "276-227-0460",
            "fax_number": "276-227-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 HOLSTON RD",
            "address_2": "SUITE B",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243824486",
            "telephone_number": "276-227-0460",
            "fax_number": "276-227-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVE",
        "first_name": "SCOTTY",
        "middle_name": "GARLAND",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102050091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972622181",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wytheville, VA

Sources for this page

Verify at the official NPI Registry.