Individual provider Active NPI

Shawn Michael Meyer, D.C., C.C.N., PMMTP

  • Rehabilitation Practitioner
  • Scottsdale, AZ
National Provider Identifier
1619932431
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
4276 Issued in AZ
Practice address
4110 N Scottsdale Rd Ste 215
Scottsdale, AZ 85251-3635
Phone
(480) 609-4244
NPI assigned
Apr 18, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 7589 AZ
Rehabilitation Practitioner 225400000X 4276 AZ Primary

Addresses

Primary practice location

4110 N Scottsdale Rd Ste 215
Scottsdale, AZ 85251-3635

Mailing address

4110 N Scottsdale Rd Ste 215
Scottsdale, AZ 85251-3635
Phone (480) 609-4244

Other identifiers 2

IdentifierTypeStateIssuer
202901918OtherAZFEDERAL TAX ID
AZ0945690OtherAZBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051012000263 AZ Practitioner - Chiropractic 6002881745 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4276AZMDRehabilitation Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regent Healthcare of Scottsdale CurrentSince May 1, 2005 Accepting new patients
Regent Healthcare at DC Ranch Current Accepting new patients

Locations

4200 S Alma School Rd
Chandler, AZ 85248
Phone (480) 234-9436

4110 N Scottsdale Rd
Ste 215
Scottsdale, AZ 85251
Phone (480) 609-4244

Organizations & group practices 3

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1619932431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 N SCOTTSDALE RD STE 215",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852513635",
            "telephone_number": "480-609-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 N SCOTTSDALE RD STE 215",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852513635",
            "telephone_number": "480-609-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "SHAWN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C., C.C.N., PMMTP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "AZ",
            "license": "7589",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "AZ",
            "license": "4276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "202901918",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0945690",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.