Individual provider Active NPI

Scott C Hale, D.C., Q.M.E.

  • Sports Physician Chiropractor
  • Placerville, CA
National Provider Identifier
1174562433
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC0166810 Issued in CA
Practice address
2804 Mallard LN
Placerville, CA 95667-8770
Phone
(530) 622-3600
Fax
(530) 622-3865
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X DC0166810 CA Primary

Addresses

Primary practice location

2804 Mallard LN
Placerville, CA 95667-8770

Mailing address

2804 Mallard LN
Placerville, CA 95667-8770
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
I20041022000929 CA Practitioner - Chiropractic 7315908332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2800 Mallard LN
Placerville, CA 95667-8770
Phone (530) 622-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC0166810CAMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Scott C Hale Doctor of Chiropractics a Professional Corp Sports Physician CurrentSince Aug 2, 2005 Accepting new patients

Locations

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

Organizations & group practices 1

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1174562433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 MALLARD LN",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956678770",
            "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": "2804 MALLARD LN",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956678770",
            "telephone_number": "530-622-3600",
            "fax_number": "530-622-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "SCOTT",
        "middle_name": "C",
        "credential": "D.C., Q.M.E.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_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 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.