Individual provider Active NPI

Scott David Fletcher, DC

  • Chiropractor
  • Boise, ID
National Provider Identifier
1265566855
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
877 Issued in ID
Practice address
5246 N Eagle Rd
Boise, ID 83713-0945
Phone
(208) 939-3000
Fax
(208) 939-3030
NPI assigned
Mar 15, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 877 ID Primary

Addresses

Primary practice location

5246 N Eagle Rd
Boise, ID 83713-0945

Mailing address

5246 N Eagle Rd
Ste 106
Boise, ID 83713-0945
Phone (208) 939-3000

Other identifiers 2

IdentifierTypeStateIssuer
C2573OtherIDBLUE CROSS
000010028569OtherIDREGENCE BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110926000567 ID Practitioner - Chiropractic 6103097076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fletcher Chiropractic PLLCGroup PAC ID 1557532413, 2 clinicians

Practice addresses (Care Compare)

5246 N Eagle Rd
Boise, ID 83713-0945
Phone (208) 939-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fletcher Chiropractic PLLC Chiropractor CurrentSince Jun 14, 2000 Accepting new patients

Locations

5246 N Eagle Rd
Boise, ID 83713
Phone (208) 939-3000

5246 N Eagle Rd
Ste 106
Boise, ID 83713

3210 E Chinden Blvd
Ste 106
Eagle, ID 83616
Phone (208) 939-3000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1265566855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5246 N EAGLE RD",
            "address_2": "STE 106",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130945",
            "telephone_number": "208-939-3000",
            "fax_number": "208-939-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5246 N EAGLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130945",
            "telephone_number": "208-939-3000",
            "fax_number": "208-939-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "SCOTT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "C2573",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010028569",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.