Scott Koltes, D.C.
Individual provider Active NPI Chiropractor · Richfield, MN
NPI 1366523375 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1366523375
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4186 (MN)
- Practice address
- 6944 Nicollet Ave S
Richfield, MN 55423-2407 - Phone
- (612) 861-8854
- Fax
- (612) 861-8816
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6944 Nicollet Ave
Richfield, MN 55423-2407
Phone (612) 861-8854
6944 Nicollet Ave S
Richfield, MN 55423-2407
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100429000830 | MN | Practitioner - Chiropractic | 5890822415 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4186 | MN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Back to Health LTD | Chiropractor | Current |
Accepting new patients |
Locations
6944 Nicollet Ave
Richfield, MN 55423
Phone (612) 861-8854
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4186 | MN | Yes |
Addresses
Primary practice location
6944 Nicollet Ave S
Richfield, MN 55423-2407
Mailing address
6944 Nicollet Ave S
Richfield, MN 55423-2407
Phone (612) 861-8854
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61G09KO | Other | MN | BC/BS PROVIDER NUMBER |
Other providers in Richfield, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.