Individual provider Active NPI

Scott Patrick Shales, DC

  • Chiropractor
  • Webster, NY
National Provider Identifier
1831100858
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X010098-1 Issued in NY
Practice address
853 Ridge Rd
Webster, NY 14580-2550
Phone
(585) 671-9210
NPI assigned
Aug 11, 2006
Sex
Male
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
Chiropractor 111N00000X X010098-1 NY Primary

Addresses

Primary practice location

853 Ridge Rd
Webster, NY 14580-2550

Mailing address

7626 Whispers LN
Ontario, NY 14519-9388
Phone (315) 524-3423

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091125000168 NY Practitioner - Chiropractic 1153460506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Odell Family Chiropractic PCGroup PAC ID 3173603768, 3 clinicians

Practice addresses (Care Compare)

853 Ridge Rd
Webster, NY 14580-2550
Phone (585) 671-9210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X010098-1NYMDChiropractor
010098NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Debole Chiropractic PLLC Chiropractor CurrentSince Dec 2, 2020 Accepting new patients
Odell Family Chiropractic PC Chiropractor CurrentSince Jan 1, 2012 Accepting new patients
Debole Chiropractic Webster PLLC Chiropractor Current Accepting new patients

Locations

6280 Route 96
Ste E
Victor, NY 14564
Phone (585) 433-5680

6280 Route 96
Victor, NY 14564
Phone (585) 433-5680

853 Ridge Rd
Webster, NY 14580
Phone (585) 671-9210

Organizations & group practices 3

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831100858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7626 WHISPERS LN",
            "city": "ONTARIO",
            "state": "NY",
            "postal_code": "145199388",
            "telephone_number": "315-524-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 RIDGE RD",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145802550",
            "telephone_number": "585-671-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALES",
        "first_name": "SCOTT",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010098-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, NY

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.
  • 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.