NPI 1619913050
Jack C. Scott, M.D.
Specialist · Fridley, MN
Active in the CMS NPI RegistryNot on the OIG exclusion listchecked Oct 16, 2026, 10:22 am EDT
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Jack C. Scott, M.D. is a health care provider (Specialist) in Fridley, Minnesota with National Provider Identifier (NPI) 1619913050. The NPI was issued on Jun 22, 2006 and the registry record was last updated on Jul 8, 2007. The registry lists a license in Minnesota.
Registry record
- NPI
- 1619913050
- Type
- Individual (NPI-1)
- Primary specialty
- Specialist 174400000X
- Practice location
- 7205 University Ave NE
Fridley, MN 55432-3134 - Phone
- (763) 571-4000
- NPI issued
- Jun 22, 2006
- Registry record updated
- Jul 8, 2007
Specialties and licenses
| Specialty | Taxonomy code | License state | License |
|---|---|---|---|
| Specialist Primary | 174400000X | Minnesota | 21065 |
Confirm license status and discipline with the state board (links in NPI Lookup).
Source: CMS National Plan and Provider Enumeration System (NPPES) and the HHS-OIG List of Excluded Individuals/Entities (list of Oct 9, 2026). Is this your record? Update it in NPPES or email info@2minutemedicine.com to have it hidden here.