Organization Active NPI

Scott Van Oosten D C Inc

  • Chiropractor
  • Lakewood, OH
National Provider Identifier
1659545200
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2217 Issued in OH
Legal business name
SCOTT VAN OOSTEN D C INC
Practice address
15711 Madison Avenue
Lakewood, OH 44107
Phone
(216) 221-5556
NPI assigned
Apr 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Authorized official

Name
Ms. Andi J Allen
Title
Office Manager
Phone
(216) 221-5556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2217 OH Primary

Addresses

Primary practice location

15711 Madison Avenue
Lakewood, OH 44107

Mailing address

3427 Bridgeport Dr.
N. Olmsted, OH 44070
Phone (216) 221-5556

Other identifiers 1

IdentifierTypeStateIssuer
0132341MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080418000369 OH Part B Supplier - Clinic/Group Practice 9931186913 Receives reassigned benefits from 1 practitioner
Practice locations: Lakewood, OH

National Provider Directory

National Provider Directory

Locations

15711 Madison Ave
Ste 101
Lakewood, OH 44107
Phone (216) 221-5556

15711 Madison Ave
Lakewood, OH 44107
Phone (216) 221-5556

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1659545200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3427 BRIDGEPORT DR.",
            "city": "N. OLMSTED",
            "state": "OH",
            "postal_code": "44070",
            "telephone_number": "216-221-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15711 MADISON AVENUE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "44107",
            "telephone_number": "216-221-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT VAN OOSTEN D C INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "ANDI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "216-221-5556",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0132341",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.