Individual provider Active NPI

Scott Joseph Haggerty, D.C

  • Chiropractor
  • North Royalton, OH
National Provider Identifier
1245511815
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4215 Issued in OH
Practice address
12891 State Rd
North Royalton, OH 44133-3971
Phone
(440) 230-2300
Fax
(440) 230-2301
NPI assigned
Sep 8, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4215 OH Primary

Addresses

Primary practice location

12891 State Rd
North Royalton, OH 44133-3971

Mailing address

12891 State Road
North Royalton, OH 44133-3851
Phone (440) 230-2300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120222000320 OH Practitioner - Chiropractic 8022276435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4215OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Physical Therapy and Rehabilitation LLC CurrentSince Feb 21, 2014 Accepting new patients

Locations

12891 State Rd
North Royalton, OH 44133
Phone (440) 230-2300

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": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1245511815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12891 STATE ROAD",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441333851",
            "telephone_number": "440-230-2300",
            "fax_number": "440-230-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12891 STATE RD",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441333971",
            "telephone_number": "440-230-2300",
            "fax_number": "440-230-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGERTY",
        "first_name": "SCOTT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-08",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Royalton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.