Active NPI
Scott Edward Lynn, D.C.
- Chiropractor
- Mooresville, NC
National Provider Identifier
1902991656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3117
- Practice address
- 386 Williamson Rd Ste 103
Mooresville, NC 28117-5929 - Phone
- (704) 658-9920
- Fax
- (704) 658-9228
- NPI assigned
- Oct 4, 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 | 3117 | NC | Primary |
Addresses
Primary practice location
386 Williamson Rd Ste 103
Mooresville, NC 28117-5929
Mailing address
112 Danica PL
Mooresville, NC 28117-4365
Phone (704) 664-0860
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 085JN | Other | NC | BCBS ID |
| 89085JN | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050222000144 | NC | Practitioner - Chiropractic | 0749232676 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3117 | NC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1902991656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 DANICA PL",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281174365",
"telephone_number": "704-664-0860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "386 WILLIAMSON RD STE 103",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281175929",
"telephone_number": "704-658-9920",
"fax_number": "704-658-9228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNN",
"first_name": "SCOTT",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "3117",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS ID",
"identifier": "085JN",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89085JN",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mooresville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.