Individual provider Active NPI

Scott E Nicholls, MD

  • Emergency Medicine Physician
  • Woodbury, MN
National Provider Identifier
1063587947
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
49580 Issued in MN
Practice address
1925 Woodwinds Dr
Woodbury, MN 55125-2270
Phone
(651) 232-0228
NPI assigned
Nov 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X EC-05-141 ME
Emergency Medicine Physician 207P00000X 49580 MN Primary
Emergency Medicine Physician 207P00000X 87321-20 WI

Addresses

Primary practice location

1925 Woodwinds Dr
Woodbury, MN 55125-2270

Mailing address

2829 University Ave SE Ste 730
Minneapolis, MN 55414-3279

Other practice location 1

235 E State St
Saint Croix Falls, WI 54024-4117
Phone (715) 483-0555

Other practice location 2

2250 NW 26th St
Owatonna, MN 55060-5503
Phone (507) 451-3850

Other practice location 3

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 232-7348

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070621000633 MN Practitioner - Emergency Medicine 5890894463 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95.56
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
EC-05-141MEMDEmergency Medicine Physician
87321-20WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Care Consultants, PA Emergency Medicine CurrentSince Sep 1, 2017 Accepting new patients
Healtheast St. John'S Hospital CurrentSince Jul 1, 2007 Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Jul 1, 2007 Accepting new patients
Ecc Addiction & Toxicology Services LLC PastSince Oct 1, 2020 Accepting new patients

Locations

200 State Ave
Faribault, MN 55021
Phone (507) 334-6451

1175 Nininger Rd
Hastings, MN 55033
Phone (651) 404-1000

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

800 E 28th St
#11112
Minneapolis, MN 55407
Phone (612) 863-4233

2829 University Ave SE
Ste 730
Minneapolis, MN 55414
Phone (612) 439-1868

2250 NW 26th St
Owatonna, MN 55060
Phone (507) 451-3850

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

1629 E Division St
River Falls, WI 54022
Phone (715) 307-6000

235 E State St
St Croix Fls, WI 54024
Phone (715) 483-3221

Interoperability endpoints

  • Direct secure messaging: snicholls630498@fairview.direct-ci.com

Organizations & group practices 4

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": "1164240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1063587947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 UNIVERSITY AVE SE STE 730",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252270",
            "telephone_number": "651-232-0228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 E State St",
            "address_purpose": "LOCATION",
            "city": "Saint Croix Falls",
            "state": "WI",
            "postal_code": "540244117",
            "country_code": "US",
            "telephone_number": "715-483-0555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2250 NW 26th St",
            "address_purpose": "LOCATION",
            "city": "Owatonna",
            "state": "MN",
            "postal_code": "550605503",
            "country_code": "US",
            "telephone_number": "507-451-3850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1575 Beam Ave",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551091126",
            "country_code": "US",
            "telephone_number": "651-232-7348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLLS",
        "first_name": "SCOTT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-23",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "EC-05-141",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "49580",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "87321-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.