Individual provider Active NPI

Scott L Anderson, FNP

  • Nurse Practitioner
  • Concord, NC
National Provider Identifier
1992778559
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201812 Issued in NC
Practice address
202D McGill Ave NW
Concord, NC 28025-4615
Phone
(704) 792-2242
Fax
(704) 792-2272
NPI assigned
Feb 13, 2006
Last updated
May 11, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 201812 NC Primary

Addresses

Primary practice location

202D McGill Ave NW
Concord, NC 28025-4615

Mailing address

202D McGill Ave NW
Concord, NC 28025-4615
Phone (704) 792-2242

Other identifiers 1

IdentifierTypeStateIssuer
P83295MedicaidNC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040205000253 NC Practitioner - Nurse Practitioner 2466345210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

1220 Spruce St
Belmont, NC 28012-3370
Phone (704) 825-5333

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc Current Accepting new patients
Caromont Medical Group Inc CurrentSince Mar 1, 2020 Accepting new patients
Caromont Medical Group Inc CurrentSince Mar 1, 2020 Accepting new patients

Locations

1220 Spruce St
Belmont, NC 28012
Phone (704) 263-0300

2240 Remount Rd
Gastonia, NC 28054
Phone (704) 671-5311

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Logan Family Resource CenterConcord, NC, CCN 341915 Federally qualified health center W-2 Managing Employee Oct 17, 2014

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 3

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1992778559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202D MCGILL AVE NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254615",
            "telephone_number": "704-792-2242",
            "fax_number": "704-792-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202D MCGILL AVE NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254615",
            "telephone_number": "704-792-2242",
            "fax_number": "704-792-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SCOTT",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "201812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P83295",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.