NPIMap

Organization Active NPI

Acu-Chiropractic Wellness Center, PA

  • Chiropractor
  • Eagan, MN
National Provider Identifier
1396828299
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3303 Issued in MN
Legal business name
ACU-CHIROPRACTIC WELLNESS CENTER, PA
Practice address
4590 Scott TRL
Suite Number 110
Eagan, MN 55122-3331
Phone
(651) 454-1000
NPI assigned
Oct 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Scott Sammon, DCNPI 1861479867
Title
President
Phone
(651) 454-1000

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4324 MN
Chiropractor 111N00000X 3303 MN Primary

Addresses

Primary practice location

4590 Scott TRL
Suite Number 110
Eagan, MN 55122-3331

Mailing address

4590 Scott TRL
Suite Number 110
Eagan, MN 55122-3331
Phone (651) 454-1000

Other identifiers 1

IdentifierTypeStateIssuer
6967167MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050912000730 MN Part B Supplier - Clinic/Group Practice 8820021892 Receives reassigned benefits from 5 practitioners
Practice locations: Eagan, MN

National Provider Directory

National Provider Directory

Locations

4590 Scott Trl
Ste 110
Saint Paul, MN 55122
Phone (651) 454-1000

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396828299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4590 SCOTT TRL",
            "address_2": "SUITE NUMBER 110",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223331",
            "telephone_number": "651-454-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 SCOTT TRL",
            "address_2": "SUITE NUMBER 110",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223331",
            "telephone_number": "651-454-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACU-CHIROPRACTIC WELLNESS CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAMMON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-454-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4324",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6967167",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.