Individual provider Active NPI

Scott Hansen, D.C.

  • Chiropractor
  • Woodbury, MN
National Provider Identifier
1578507927
Registry record updated Nov 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3994 Issued in MN
Practice address
2165 Woodlane Dr
Suite 102
Woodbury, MN 55125-2916
Phone
(651) 735-9353
Fax
(651) 735-8282
NPI assigned
Jun 16, 2006
Last updated
Nov 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3994 MN Primary

Addresses

Primary practice location

2165 Woodlane Dr
Suite 102
Woodbury, MN 55125-2916

Mailing address

2165 Woodlane Dr
Suite 102
Woodbury, MN 55125-2916
Phone (651) 735-9353

Other identifiers 2

IdentifierTypeStateIssuer
5378488OtherMNSTATE TAX ID
996448700MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060623000183 MN Practitioner - Chiropractic 4183636780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2165 Woodlane Dr
Suite 102
Woodbury, MN 55125-2916

2165 Woodlane Dr
Suite 102
Woodbury, MN 55125-3055
Phone (651) 735-9353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3994MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeline Chiropractic , P.a. Chiropractor CurrentSince Jan 23, 2007 Accepting new patients

Locations

2165 Woodlane Dr
Ste 102
Woodbury, MN 55125
Phone (651) 356-9160

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, 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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226275200000",
    "number": "1578507927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2165 WOODLANE DR",
            "address_2": "SUITE 102",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252916",
            "telephone_number": "651-735-9353",
            "fax_number": "651-735-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 WOODLANE DR",
            "address_2": "SUITE 102",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252916",
            "telephone_number": "651-735-9353",
            "fax_number": "651-735-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "SCOTT",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2008-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE TAX ID",
            "identifier": "5378488",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "996448700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.