Individual provider Active NPI

Scott Davis, D.C.

  • Chiropractor
  • Los Alamitos, CA
National Provider Identifier
1629485750
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
33006 Issued in CA
Practice address
4012 Katella Ave Ste 101
Los Alamitos, CA 90720-3448
Phone
(562) 493-4473
Fax
(562) 667-3893
NPI assigned
Jul 21, 2014
Last updated
May 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 33006 CA Primary

Addresses

Primary practice location

4012 Katella Ave Ste 101
Los Alamitos, CA 90720-3448

Mailing address

4012 Katella Ave Ste 101
Los Alamitos, CA 90720-3448
Phone (562) 493-4473

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161121002618 CA Practitioner - Chiropractic 5890074595 Practice locations: Los Alamitos, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4012 Katella Ave
Suite 101
Los Alamitos, CA 90720-3448
Phone (562) 493-4473

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33006CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mexusa LLC CurrentSince Jun 5, 2022 Accepting new patients
Shahba Body Revive Chiropractic Corporation Chiropractor PastSince Nov 19, 2023 Accepting new patients
C & H Pharmacy PastSince Jun 5, 2022 Accepting new patients

Locations

4012 Katella Ave
Ste 101
Los Alamitos, CA 90720
Phone (562) 431-1131

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1629485750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4012 KATELLA AVE STE 101",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203448",
            "telephone_number": "562-493-4473",
            "fax_number": "562-667-3893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4012 KATELLA AVE STE 101",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203448",
            "telephone_number": "562-493-4473",
            "fax_number": "562-667-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SCOTT",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-21",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.