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JACK C. SCOTT M.D.
NPI 1619913050
Specialist in Fridley, MN

Active since June 22, 2006
7205 UNIVERSITY AVE NE, FRIDLEY, MN 55432(763) 571-4000(763) 571-7202 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Jack C. Scott M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK C. SCOTT M.D. (NPI 1619913050) is an individual specialist in Fridley, Minnesota, licensed in Minnesota (21065) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1619913050
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameJACK C. SCOTTCredential: M.D.
Location Address7205 UNIVERSITY AVE NEFridley, MN 55432-3134
Mailing Address7205 University Ave NeFridley, MN 55432-3134 · (763) 571-4000 · Fax (763) 571-7202
Phone(763) 571-4000
Fax(763) 571-7202
Sole ProprietorNo
Enumeration DateJune 22, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1619913050 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in MN · 21065
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
7205 UNIVERSITY AVE NE, Fridley, MN 55432
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Other Identifiers 2

Medicaid870787100MN
Medicare UPINA95882MN

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEVEN E KEMPERS M.D.
Specialist
7205 UNIVERSITY AVE NE
FRIDLEY, MN 55432
Anoka County (763) 571-4000
DR. SCOTT PAUL PRAWER MD
Dermatology
7205 UNIVERSITY AVE NE
FRIDLEY, MN 55432
Anoka County (763) 571-4000
NAIMA YAASIIN QAYBDID
Behavior Technician
7205 UNIVERSITY AVE NE
FRIDLEY, MN 55432
Anoka County (612) 298-7636
AISHA A HASSAN
Behavior Technician
7205 UNIVERSITY AVE NE
FRIDLEY, MN 55432
Anoka County (612) 298-7636
HANA MOHAMED ALI
Behavior Technician
7205 UNIVERSITY AVE NE
FRIDLEY, MN 55432
Anoka County (612) 298-7636
MARYAM ALI ARTAN
Behavior Technician
7205 UNIVERSITY AVE NE
FRIDLEY, MN 55432
Anoka County (612) 208-0729
HABSA MUHUDIIN AHMED
Behavior Technician
7205 UNIVERSITY AVE NE
FRIDLEY, MN 55432
Anoka County (612) 208-0729
NASTEHO MOHAMED MOHAMUD
Behavior Technician
7205 UNIVERSITY AVE NE
FRIDLEY, MN 55432
Anoka County (612) 298-7636

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Scott's NPI number?

The NPI number for Jack Scott is 1619913050. It was assigned to this individual provider in the NPPES registry on June 22, 2006.

Where is Jack Scott located?

Jack Scott practices at 7205 University Ave NE, Fridley, MN 55432. The listed phone number is (763) 571-4000.

What is Jack Scott's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Jack Scott was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.