Scott Robert Underwood, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038011164 Issued in IL

Practice address

787 Sunset Blvd
Suite 200
O Fallon, IL 62269-1960

Phone

(618) 624-2400

Fax

(618) 624-2407

NPI assigned

May 14, 2008

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

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Underwood Chiropractic L.L.C.

  • Chiropractor
  • O Fallon, IL
  • NPI 1679730568
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1508033960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "787 SUNSET BLVD",
            "address_2": "SUITE 200",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691960",
            "telephone_number": "618-624-2400",
            "fax_number": "618-624-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 SUNSET BLVD",
            "address_2": "SUITE 200",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691960",
            "telephone_number": "618-624-2400",
            "fax_number": "618-624-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "SCOTT",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dezmauri Tyler
• Randi R Tyler, D.C.
• Christina Unangst, RBT
• Underwood Chiropractic L.L.C.
• Lynn Sewester Underwood, MA, LCPC
• United Surgical Institiute, PLLC
• Untangled Minds PLLC
• Upcare LLC
• Urology of St. Louis, Inc.
• Usc Telehealth

• Chiropractor in O Fallon, IL
• Providers in O Fallon, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; 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.