Organization Active NPI

Scott C Hale Doctor of Chiropractics a Professional Corp

  • Sports Physician Chiropractor
  • Placerville, CA
National Provider Identifier
1174551238
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC0166810 Issued in CA
Legal business name
SCOTT C HALE DOCTOR OF CHIROPRACTICS A PROFESSIONAL CORP
Practice address
6390 Runnymeade Dr Ste B
Placerville, CA 95667-8634
Phone
(530) 622-3600
Fax
(530) 622-3865
NPI assigned
Jun 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Authorized official

Name
Dr. Scott C Hale, D.C., Q.M.E.NPI 1174562433
Title
Doctor/Owner
Phone
(530) 622-3600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X DC0166810 CA Primary

Addresses

Primary practice location

6390 Runnymeade Dr Ste B
Placerville, CA 95667-8634

Mailing address

6390 Runnymeade Dr Ste B
Placerville, CA 95667-8634
Phone (530) 622-3600

Other identifiers 1

IdentifierTypeStateIssuer
DC0166810OtherCACHIROPRACTIC LICENCE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071222000052 CA Part B Supplier - Clinic/Group Practice 7416047816 Receives reassigned benefits from 1 practitioner
Practice locations: Placerville, CA

National Provider Directory

National Provider Directory

Locations

2800 Mallard Ln
Placerville, CA 95667
Phone (530) 622-3600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1174551238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6390 RUNNYMEADE DR STE B",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956678634",
            "telephone_number": "530-622-3600",
            "fax_number": "530-622-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6390 RUNNYMEADE DR STE B",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956678634",
            "telephone_number": "530-622-3600",
            "fax_number": "530-622-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT C HALE DOCTOR OF CHIROPRACTICS A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "530-622-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., Q.M.E."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC0166810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENCE #",
            "identifier": "DC0166810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.