NPIMap

Individual provider Active NPI

Charles C Scott, M.D.

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1992906143
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-7951 Issued in AR
Practice address
2000 Town Ctr Ste 1900
Southfield, MI 48075-1152
Phone
(657) 237-2450
Fax
(714) 455-3686
NPI assigned
May 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E-7951 AR
Emergency Medicine Physician 207P00000X 0101245862 VA
Emergency Medicine Physician 207P00000X 2009-01263 NC
Family Medicine Physician 207Q00000X E-7951 AR Primary

Addresses

Primary practice location

2000 Town Ctr Ste 1900
Southfield, MI 48075-1152

Mailing address

506 N Elm St
Little Rock, AR 72205-3928

Other practice location 1

101 Manning Dr
Room 1107G West Wing
Chapel Hill, NC 27514-4220
Phone (919) 966-1072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130613000193 AR Practitioner - Family PracticePractitioner - General PracticePractitioner - Emergency Medicine 8820139785 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009-01263NCMDEmergency Medicine Physician
0101245862VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Regional Medical Center Inc Family Medicine CurrentSince Oct 10, 2016 Accepting new patients
CHI St Vincent Hospital Hot Springs CurrentSince Apr 1, 2015 Accepting new patients
Shiloh Emergency Group PLLC Emergency Medicine CurrentSince Jun 20, 2020 Accepting new patients
Conway Regional Medical Center Inc CurrentSince Oct 10, 2016 Accepting new patients
CHI St Vincent Hospital Hot Springs Emergency Medicine CurrentSince Apr 1, 2015 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Person Emergency Services PLLC Emergency Medicine Past Accepting new patients
Emergency Physician Associates of North Carolina, P.C. Emergency Medicine Past Accepting new patients
Emergency Coverage, LLC Emergency Medicine Past Accepting new patients
Neuse River Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

2302 College Ave
Conway, AR 72034
Phone (501) 329-3831

300 Werner St
Hot Springs National Park, AR 71913
Phone (501) 622-1000

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

4 Hospital Dr
Morrilton, AR 72110
Phone (501) 977-2300

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

Interoperability endpoints

  • Direct secure messaging: cscott@landmarkhealth-direct.org

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
GentivaRussellville, AR, CCN 041528 Hospice Contracted Managing Employee Nov 27, 2019

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 10

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1992906143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 N ELM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 TOWN CTR STE 1900",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480751152",
            "telephone_number": "657-237-2450",
            "fax_number": "714-455-3686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Manning Dr",
            "address_2": "Room 1107G West Wing",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275144220",
            "country_code": "US",
            "telephone_number": "919-966-1072",
            "fax_number": "919-966-0290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "CHARLES",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-7951",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101245862",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2009-01263",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-7951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.