Individual provider Active NPI

Susan Jane Scott, LICSW

  • Clinical Social Worker
  • Bemidji, MN
National Provider Identifier
1770704165
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
820 Issued in MN
Practice address
514 Beltrami Ave NW
Bemidji, MN 56601-3010
Phone
(218) 444-2845
Fax
(218) 444-2847
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 820 MN Primary

Addresses

Primary practice location

514 Beltrami Ave NW
Bemidji, MN 56601-3010

Mailing address

514 Beltrami Ave NW
Bemidji, MN 56601-3010
Phone (218) 444-2845

Other identifiers 1

IdentifierTypeStateIssuer
163M7SCOtherMNBLUE CROSS BLUE SHIELD MN

Other names 1

  • Susan J Scott Other name

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

State licenses

LicenseStateTypeSpecialty
820MNMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770704165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 BELTRAMI AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013010",
            "telephone_number": "218-444-2845",
            "fax_number": "218-444-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 BELTRAMI AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013010",
            "telephone_number": "218-444-2845",
            "fax_number": "218-444-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "SUSAN",
        "middle_name": "JANE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MN",
            "identifier": "163M7SC",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "SCOTT",
            "middle_name": "J",
            "credential": "LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.