DataLabs

datalabs.health made in the usa

Contact us Sign in | Documentation |

divider

Medicare/Medicaid Verification Programs divider

divider

Medicare Verification Program divider

divider

1336146703

NPI Code Detail

MEDICARE: SCOTT J FILLMORE MD

MEDICARE: SCOTT J FILLMORE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225400000X	Rehabilitation Practitioner	H9633	TX
2	208100000X	Physical Medicine & Rehabilitation Physician	5962	ND

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
12	250003082	OTHER	TX	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	979392	OTHER	TX	FOCUS
2	208100000X	OTHER	TX	PMR, SPECIALTY CODE
3	377226600	OTHER	TX	W/C
4	760420564	OTHER	TX	TAX ID
5	00H04C	OTHER	TX	BC/BS OF TEXAS
6	123880501	OTHER	TX	METHODIST CARE
7	541659	OTHER	TX	USA MANAGED CARE ORG
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	54349	OTHER	TX	HMO BLUE STAR PLUS
10	6800563003	OTHER	TX	CIGNA
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	4511475	OTHER	TX	AETNA
14	813691	OTHER	TX	CIGNA

General Provider Information

NPI Number	:	1336146703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT J FILLMORE MD

Provider Business Mailing Address
First Line	:	801 BROADWAY N
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58102-3641
Country	:	US
Telephone Number	:	701-234-2203
Fax Number	:	701-234-2899

Provider Business Practice Location Address
First Line	:	801 BROADWAY N
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58102-3641
Country	:	US
Telephone Number	:	701-234-2203
Fax Number	:	701-234-2899

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	01/18/2012

Similar Medicare Providers

1669979514 — KENT JOHN PETERSON MD
Practice Location Address:

801 BROADWAY N
FARGO, ND
58102-3641

Practice Phone: 801-234-2000
Practice Fax:

1912856113 — ALEXANDRA KUENNEN
Practice Location Address:

801 BROADWAY N
FARGO, ND
58102-3641

Practice Phone: 701-234-2000
Practice Fax:

1801258280 — KATIE DANIELSON APRN, CNP
Practice Location Address:

801 BROADWAY N
FARGO, ND
58102-3641

Practice Phone: 701-234-2000
Practice Fax:

1528062924 — MARK F FISHER MD
Practice Location Address:

801 BROADWAY N
FARGO, ND
58102-3641

Practice Phone: 701-234-2309
Practice Fax:

1942206990 — DR. ANDREW WADE OSBURN M.D.
Practice Location Address:

801 BROADWAY N
FARGO, ND
58102-3641

Practice Phone: 701-234-2000
Practice Fax:

1942209549 — DR. ROBERT SCOT DAVIDSON MD
Practice Location Address:

801 BROADWAY N
FARGO, ND
58102-3641

Practice Phone: 701-234-2000
Practice Fax: 701-234-2345

Directions to “ SCOTT J FILLMORE MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.