Individual provider Active NPI

Scot Montgomery Hunter, MA, LP

  • Clinical Psychologist
  • New Brighton, MN
National Provider Identifier
1639191117
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP2075 Issued in MN
Practice address
1900 Silver Lake Rd NW
Suite 115
New Brighton, MN 55112-1786
Phone
(651) 628-4993
Fax
(651) 379-1772
NPI assigned
Jul 24, 2006
Last updated
Feb 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP2075 MN Primary

Addresses

Primary practice location

1900 Silver Lake Rd NW
Suite 115
New Brighton, MN 55112-1786

Mailing address

1900 Silver Lake Rd NW
Suite 115
New Brighton, MN 55112-1786
Phone (651) 628-4993

Other identifiers 1

IdentifierTypeStateIssuer
683753100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LP2075MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Support Services Inc. PastSince Oct 10, 2009 Accepting new patients
Family Support Services Inc. Past Accepting new patients

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, 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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1639191117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE 115",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-4993",
            "fax_number": "651-379-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE 115",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "651-628-4993",
            "fax_number": "651-379-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTER",
        "first_name": "SCOT",
        "middle_name": "MONTGOMERY",
        "credential": "MA, LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP2075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "683753100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brighton, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.