Individual provider Active NPI

Amie C Scantlin, DPM

  • Podiatrist
  • Glencoe, MN
National Provider Identifier
1669460721
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
687 Issued in MN
Practice address
1805 Hennepin Ave N
Glencoe Regional Health Services
Glencoe, MN 55336-1416
Phone
(320) 864-3121
Fax
(320) 864-7887
NPI assigned
Oct 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 687 MN Primary

Addresses

Primary practice location

1805 Hennepin Ave N
Glencoe Regional Health Services
Glencoe, MN 55336-1416

Mailing address

1805 Hennepin Ave N
Glencoe, MN 55336-1416
Phone (320) 864-3121

Other identifiers 1

IdentifierTypeStateIssuer
249088900MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ascantlin157049@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100215000778 MN Practitioner - Podiatry 3072657030 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glencoe Regional Health ServicesGroup PAC ID 1759292980, 45 clinicians

Practice addresses (Care Compare)

1805 Hennepin Ave N
Glencoe, MN 55336-1416
Phone (320) 864-3121

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
687MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Glencoe Regional Health Services CurrentSince Aug 1, 2002 Accepting new patients
Glencoe Regional Health Services CurrentSince Aug 1, 2002 Accepting new patients
Greater Columbus Foot & Ankle Group Past Accepting new patients

Locations

1805 Hennepin Ave N
Glencoe, MN 55336
Phone (320) 864-3121

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1669460721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 HENNEPIN AVE N",
            "city": "GLENCOE",
            "state": "MN",
            "postal_code": "553361416",
            "telephone_number": "320-864-3121",
            "fax_number": "320-864-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 HENNEPIN AVE N",
            "address_2": "GLENCOE REGIONAL HEALTH SERVICES",
            "city": "GLENCOE",
            "state": "MN",
            "postal_code": "553361416",
            "telephone_number": "320-864-3121",
            "fax_number": "320-864-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANTLIN",
        "first_name": "AMIE",
        "middle_name": "C",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "249088900",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ascantlin157049@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1805 Hennepin Ave N",
            "address_2": "Glencoe Regional Health Services",
            "city": "Glencoe",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553361416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glencoe, MN

Sources for this page

Verify at the official NPI Registry.