Organization Active NPI

Scott Chiropractic Center Inc

  • Chiropractor
  • Spokane, WA
National Provider Identifier
1285859298
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
L0643329 Issued in WA
Legal business name
SCOTT CHIROPRACTIC CENTER INC
Practice address
5625 N Wall St
Spokane, WA 99205-6435
Phone
(509) 482-1982
Fax
(509) 482-1983
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Authorized official

Name
Dr. Scott Maystrovich, DCNPI 1114910270
Title
President
Phone
(509) 482-1982

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X L0643329 WA Primary

Addresses

Primary practice location

5625 N Wall St
Spokane, WA 99205-6435

Mailing address

5625 N Wall St
Spokane, WA 99205-6435
Phone (509) 482-1982

Other identifiers 4

IdentifierTypeStateIssuer
2026813MedicaidWA
103310600OtherWAFEDERAL LABOR AND INDUSTR
2433MAOtherWAASURIS
0157424OtherWALABOR AND INDUSTRIES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040319001335 WA Part B Supplier - Clinic/Group Practice 1850281924 Receives reassigned benefits from 1 practitioner
Practice locations: Spokane, WA

National Provider Directory

National Provider Directory

Locations

5625 N Wall St
Spokane, WA 99205
Phone (509) 328-5560

5616 N Wall St
Spokane, WA 99205
Phone (509) 482-1982

Practitioners & affiliated clinicians

Practitioners 3

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": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302480000000",
    "number": "1285859298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 N WALL ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992056435",
            "telephone_number": "509-482-1982",
            "fax_number": "509-482-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 N WALL ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992056435",
            "telephone_number": "509-482-1982",
            "fax_number": "509-482-1983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT CHIROPRACTIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2011-04-11",
        "status": "A",
        "authorized_official_last_name": "MAYSTROVICH",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-482-1982",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "L0643329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2026813",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL LABOR AND INDUSTR",
            "identifier": "103310600",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASURIS",
            "identifier": "2433MA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0157424",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; 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.