Individual provider Active NPI

Scott Walter, DC

  • Chiropractor
  • Eden Prairie, MN
National Provider Identifier
1770813842
Registry record updated Jan 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5332 Issued in MN
Practice address
17578 Haralson Dr
Eden Prairie, MN 55347-3535
Phone
(701) 388-2000
NPI assigned
Jan 12, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 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 5332 MN Primary

Addresses

Primary practice location

17578 Haralson Dr
Eden Prairie, MN 55347-3535

Mailing address

17578 Haralson Dr
Eden Prairie, MN 55347-3535
Phone (701) 388-2000

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5332MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Trillium Chiropractic, PLLC Chiropractor CurrentSince Dec 14, 2021 Accepting new patients
Midwest Chiropractic and Wellness Center P.a. Chiropractor PastSince Feb 1, 2015 Accepting new patients

Locations

13700 Reimer Dr N
Ste 250
Maple Grove, MN 55311
Phone (763) 420-2226

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": "1263254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263254400000",
    "number": "1770813842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17578 HARALSON DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553473535",
            "telephone_number": "701-388-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17578 HARALSON DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553473535",
            "telephone_number": "701-388-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-12",
        "last_updated": "2010-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; 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.