Individual provider Active NPI

Scott Alan Tannehill

  • Chiropractor
  • Culver City, CA
National Provider Identifier
1609933852
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
18663 Issued in CA
Practice address
10811 Washington Blvd Ste 250
Culver City, CA 90232-3670
Phone
(310) 475-9111
Fax
(310) 943-1752
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 18663 CA Primary

Addresses

Primary practice location

10811 Washington Blvd Ste 250
Culver City, CA 90232-3670

Mailing address

10811 Washington Blvd Ste 250
Culver City, CA 90232-3670
Phone (310) 475-9111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120109000654 CA Practitioner - Chiropractic 8224204516 Practice locations: Culver City, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5175 Overland Ave
Culver City, CA 90230-4913
Phone (310) 475-9111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18663CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Occupational Medical Group, Inc. Past Accepting new patients
Oasis Neurology and Pain Institute Inc Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1609933852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10811 WASHINGTON BLVD STE 250",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323670",
            "telephone_number": "310-475-9111",
            "fax_number": "310-943-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10811 WASHINGTON BLVD STE 250",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323670",
            "telephone_number": "310-475-9111",
            "fax_number": "310-943-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNEHILL",
        "first_name": "SCOTT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "18663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.