Provider Demographics
NPI:1356309066
Name:OMMERT, SCOTT LINDSEY (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:LINDSEY
Last Name:OMMERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 CLEVELAND ROAD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-9022
Mailing Address - Country:US
Mailing Address - Phone:419-663-5200
Mailing Address - Fax:419-663-3333
Practice Address - Street 1:199 CLEVELAND ROAD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-9022
Practice Address - Country:US
Practice Address - Phone:419-663-5200
Practice Address - Fax:419-663-3333
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2195111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000139578OtherBLUE CROSS BLUE SHIELD
OH34181447900OtherWORKERS COMP
OH0147522Medicaid
U56225Medicare UPIN
OH0147522Medicaid