Active NPI
Scot L Sorum, D.C.
- Chiropractor
- Saint Paul, MN
National Provider Identifier
1780744987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3639
- Practice address
- 506 Lexington Pkwy N
Saint Paul, MN 55104-4644 - Phone
- (651) 224-1921
- Fax
- (651) 224-1936
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3639 | MN | Primary |
Addresses
Primary practice location
506 Lexington Pkwy N
Saint Paul, MN 55104-4644
Mailing address
506 N. Lexington Pkwy
St. Paul, MN 55104
Phone (651) 224-1921
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9746871 | Medicaid | MN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3639 | MN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780744987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 N. LEXINGTON PKWY",
"city": "ST. PAUL",
"state": "MN",
"postal_code": "55104",
"telephone_number": "651-224-1921",
"fax_number": "651-224-1936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 LEXINGTON PKWY N",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551044644",
"telephone_number": "651-224-1921",
"fax_number": "651-224-1936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORUM",
"first_name": "SCOT",
"middle_name": "L",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "3639",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9746871",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, 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.