Individual provider Active NPI

Travis Patrick Scott, D.C.

  • Chiropractor
  • Rosemount, MN
National Provider Identifier
1407897432
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4960 Issued in MN
Practice address
15067 Crestone Ave W
Rosemount, MN 55068-4586
Phone
(952) 322-4440
NPI assigned
Jun 9, 2006
Last updated
Jun 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4960 MN Primary

Addresses

Primary practice location

15067 Crestone Ave W
Rosemount, MN 55068-4586

Mailing address

15067 Crestone Ave W
Rosemount, MN 55068-4586
Phone (952) 322-4440

Other practice location 1

4717 Clark Ave
White Bear Lake, MN 55110-3221
Phone (651) 762-8040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080331000043 MN Practitioner - Chiropractic 7911083092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott Chiropractic Clinic PLLCGroup PAC ID 8921282963, 4 clinicians

Practice addresses (Care Compare)

15067 Crestone Ave W
Rosemount, MN 55068-4586
Phone (952) 322-4440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Scott Chiropractic Clinic PLLC Chiropractor CurrentSince Mar 1, 2011 Accepting new patients
Carlson Chiropractic Corporation Chiropractor PastSince Jun 15, 2003 Accepting new patients

Locations

15067 Crestone Ave W
Rosemount, MN 55068
Phone (952) 322-4440

Organizations & group practices 2

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1407897432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15067 CRESTONE AVE W",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550684586",
            "telephone_number": "952-322-4440",
            "fax_number": "952-322-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15067 CRESTONE AVE W",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550684586",
            "telephone_number": "952-322-4440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4717 Clark Ave",
            "address_purpose": "LOCATION",
            "city": "White Bear Lake",
            "state": "MN",
            "postal_code": "551103221",
            "country_code": "US",
            "telephone_number": "651-762-8040",
            "fax_number": "651-762-8070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "TRAVIS",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosemount, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.