Provider Demographics
NPI:1134116205
Name:SCOTT, CHAD C (FNP MSN)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:C
Last Name:SCOTT
Suffix:
Gender:M
Credentials:FNP MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-2038
Mailing Address - Country:US
Mailing Address - Phone:731-968-3646
Mailing Address - Fax:731-968-1807
Practice Address - Street 1:200 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-2038
Practice Address - Country:US
Practice Address - Phone:731-968-3646
Practice Address - Fax:731-968-1807
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN118564207Q00000X
TN7743363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4190376OtherBCBS
TN44002OtherTLC
TN3902350Medicaid
TN56826600OtherUS DEPT OF LABOR
TN1505103Medicaid
TN1505103Medicaid
103I501490Medicare PIN
TN44002OtherTLC