Basic Information
Provider Information | |||||||||
NPI: | 1437258522 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | MCGEARY | ||||||||
FirstName: | SCOTT | ||||||||
MiddleName: | ALAN | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 212 ASHVILLE AVE | ||||||||
Address2: | SUITE 10 | ||||||||
City: | CARY | ||||||||
State: | NC | ||||||||
PostalCode: | 27511 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9198591136 | ||||||||
FaxNumber: | 9198594240 | ||||||||
Practice Location | |||||||||
Address1: | 212 ASHVILLE AVE | ||||||||
Address2: | SUITE 10 | ||||||||
City: | CARY | ||||||||
State: | NC | ||||||||
PostalCode: | 27511 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9198591136 | ||||||||
FaxNumber: | 9198594240 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/22/2006 | ||||||||
LastUpdateDate: | 07/08/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 31582 | NC | Y |   | Allopathic & Osteopathic Physicians | Pediatrics |   |
ID Information
ID | Type | State | Issuer | Description | 2028327 | 01 |   | MEDICARE/CIGNA | OTHER | 8956555 | 05 | NC |   | MEDICAID | 3131308 | 01 |   | CIGNA | OTHER | 6656692 | 01 |   | UNITED | OTHER | A4515A | 01 |   | MEDCOST | OTHER | P00285123 | 01 |   | MEDICARE-RAILROAD | OTHER | 4550780 | 01 |   | AETNA | OTHER | 56555 | 01 |   | BCBS | OTHER |