Active NPI
Shannon Jay Score, DC
- Chiropractor
- Lakeville, MN
National Provider Identifier
1417976648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- C2095
- Practice address
- 10551 165TH St W
Lakeville, MN 55044-5737 - Phone
- (952) 435-5300
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | C2095 | MN | Primary |
Addresses
Primary practice location
10551 165TH St W
Lakeville, MN 55044-5737
Mailing address
10551 165TH St W
Lakeville, MN 55044-5737
Phone (952) 435-5300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 88G89SC | Other | FM | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10551 165TH St W
Lakeville, MN 55044-5737
Phone (952) 435-5300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2095 | MN | MD | Marriage & Family Therapist |
| C2095 | MN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Wellness Center, Inc. | Chiropractor | Current | Accepting new patients |
Locations
1895 Plaza Dr
Ste 200
Eagan, MN 55122
Phone (651) 688-8886
10551 165th St W
Lakeville, MN 55044
Phone (952) 435-5300
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417976648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10551 165TH ST W",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550445737",
"telephone_number": "952-435-5300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10551 165TH ST W",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550445737",
"telephone_number": "952-435-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCORE",
"first_name": "SHANNON",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "C2095",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "88G89SC",
"state": "FM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lakeville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.