Individual provider Active NPI

Paul Montgomery Scott, DC

  • Chiropractor
  • Camas, WA
National Provider Identifier
1659323400
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00002753 Issued in WA
Practice address
1905 SE 192ND Ave
Suite 111
Camas, WA 98607-7484
Phone
(360) 844-5671
Fax
(360) 954-5413
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00002753 WA Primary
Chiropractor 111N00000X 5754 CO
Chiropractor 111N00000X 272823 OR

Addresses

Primary practice location

1905 SE 192ND Ave
Suite 111
Camas, WA 98607-7484

Mailing address

1905 SE 192ND Ave
Suite 111
Camas, WA 98607-7484
Phone (360) 844-5671

Other identifiers 1

IdentifierTypeStateIssuer
2014686MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120330000529 WA Practitioner - Chiropractic 6204829518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1905 SE 192ND Ave
Suite 111
Camas, WA 98607-7415
Phone (360) 954-5111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5754COMDChiropractor
272823ORMDChiropractor
025202WAMDChiropractor
CH00002753WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Care Center NW PS Inc Chiropractor CurrentSince Jan 1, 2003 Accepting new patients

Locations

1905 SE 192nd Ave
Ste 111
Camas, WA 98607
Phone (360) 844-5671

5500 NE 109th Ct
Ste O
Vancouver, WA 98662
Phone (360) 253-6503

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1659323400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 SE 192ND AVE",
            "address_2": "SUITE 111",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986077484",
            "telephone_number": "360-844-5671",
            "fax_number": "360-954-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 SE 192ND AVE",
            "address_2": "SUITE 111",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986077484",
            "telephone_number": "360-844-5671",
            "fax_number": "360-954-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "PAUL",
        "middle_name": "MONTGOMERY",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00002753",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5754",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "272823",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2014686",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camas, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.