Active NPI
Scott Charles Penney, D.C.
- Chiropractor
- Jordan, MN
National Provider Identifier
1821331117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5879
- Practice address
- 401 Broadway St S
Jordan, MN 55352-1701 - Phone
- (952) 492-5253
- Fax
- (952) 456-6966
- NPI assigned
- Apr 4, 2013
- Last updated
- Nov 28, 2018
- 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 | 5879 | MN | Primary |
Addresses
Primary practice location
401 Broadway St S
Jordan, MN 55352-1701
Mailing address
209 Water St
Jordan, MN 55352-1518
Phone (952) 492-5253
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2013
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
209 Water St
Jordan, MN 55352-1518
Phone (952) 492-5253
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5879 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarke County Chiropractic, LLC | Chiropractor | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Chiropractor
- Jordan, MN
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543363200000",
"number": "1821331117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 WATER ST",
"city": "JORDAN",
"state": "MN",
"postal_code": "553521518",
"telephone_number": "952-492-5253",
"fax_number": "952-456-6966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 BROADWAY ST S",
"city": "JORDAN",
"state": "MN",
"postal_code": "553521701",
"telephone_number": "952-492-5253",
"fax_number": "952-456-6966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNEY",
"first_name": "SCOTT",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-04",
"last_updated": "2018-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "5879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jordan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; 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.