Individual provider Active NPI

Scott P Derouen, DC

  • Chiropractor
  • Lake Charles, LA
National Provider Identifier
1720062177
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1050 Issued in LA
Practice address
1210 E McNeese St
Lake Charles, LA 70607-4756
Phone
(337) 502-5303
Fax
(337) 479-2391
NPI assigned
Nov 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1050 LA Primary

Addresses

Primary practice location

1210 E McNeese St
Lake Charles, LA 70607-4756

Mailing address

1210 E McNeese St
Lake Charles, LA 70607-4756
Phone (337) 502-5303

Other identifiers 1

IdentifierTypeStateIssuer
350052044OtherLARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100225000873 LA Practitioner - Chiropractic 3678617859 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1210 E McNeese St
Lake Charles, LA 70607-4756
Phone (337) 502-5303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1050LAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Scott P Derouen DC PC Chiropractor CurrentSince Sep 14, 1995 Accepting new patients
Center for Chiropractic and Rehabilitation Iowa, LLC Chiropractor CurrentSince Mar 17, 2025 Accepting new patients

Locations

203 E Miller Ave
Ste F
Iowa, LA 70647
Phone (337) 502-5303

1210 E McNeese St
Lake Charles, LA 70607
Phone (337) 502-5303

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1720062177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 E MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706074756",
            "telephone_number": "337-502-5303",
            "fax_number": "337-479-2391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 E MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706074756",
            "telephone_number": "337-502-5303",
            "fax_number": "337-479-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROUEN",
        "first_name": "SCOTT",
        "middle_name": "P",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350052044",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; 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.