Individual provider Active NPI

Dewey Charles Scarbrough, PA-C

  • Physician Assistant
  • White Hall, AR
National Provider Identifier
1972622652
Registry record updated Apr 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-255 Issued in AR
Practice address
109 Frankie Lane
White Hall, AR 71602
Phone
(870) 247-1441
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2013

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 PA-255 AR Primary

Addresses

Primary practice location

109 Frankie Lane
White Hall, AR 71602

Mailing address

109 Overland TRL
White Hall, AR 71602-4778
Phone (870) 692-8023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20160419000913 AR Practitioner - Physician Assistant 7315245701 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Infirmary Medical Center CurrentSince Jun 1, 2019 Accepting new patients
St Vincent Infirmary Medical Center CurrentSince Jun 1, 2019 Accepting new patients

Locations

10100 Kanis Rd
Little Rock, AR 72205
Phone (501) 255-6000

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

2215 Wildwood Ave
Sherwood, AR 72120
Phone (501) 522-7100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365379200000",
    "number": "1972622652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 OVERLAND TRL",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716024778",
            "telephone_number": "870-692-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 FRANKIE LANE",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "71602",
            "telephone_number": "870-247-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARBROUGH",
        "first_name": "DEWEY",
        "middle_name": "CHARLES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2013-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Hall, AR

Sources for this page

Verify at the official NPI Registry.