Scot Thomas Anderson, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

608 Issued in WY

Practice address

350 E Broadway
Jackson, WY 83001

Phone

(307) 734-6006

Fax

(360) 234-6006

NPI assigned

Mar 3, 2009

Last updated

Mar 3, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1477793537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 E BROADWAY",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83001",
            "telephone_number": "307-734-6006",
            "fax_number": "360-234-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E BROADWAY",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83001",
            "telephone_number": "307-734-6006",
            "fax_number": "360-234-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SCOT",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WY",
            "license": "608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Physician Chiropractor in Jackson, WY
• Providers in Jackson, WY by specialty
• Sports Physician Chiropractor in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.