Individual provider Active NPI

Roger Leland Skierka, MD

  • Family Medicine Physician
  • Shell Rock, IA
National Provider Identifier
1003887332
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32033 Issued in IA
Practice address
513 N Cherry St
Shell Rock, IA 50670
Phone
(319) 885-6530
Fax
(319) 885-6535
NPI assigned
Jan 26, 2006
Last updated
Oct 3, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32033 IA Primary

Addresses

Primary practice location

513 N Cherry St
Shell Rock, IA 50670

Mailing address

PO Box 665
513 N Cherry St
Shell Rock, IA 50670
Phone (319) 885-6530

Other identifiers 1

IdentifierTypeStateIssuer
7138610MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32033IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd County Memorial Hospital Commission Family Medicine Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1003887332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 665",
            "address_2": "513 N CHERRY ST",
            "city": "SHELL ROCK",
            "state": "IA",
            "postal_code": "50670",
            "telephone_number": "319-885-6530",
            "fax_number": "319-885-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 N CHERRY ST",
            "city": "SHELL ROCK",
            "state": "IA",
            "postal_code": "50670",
            "telephone_number": "319-885-6530",
            "fax_number": "319-885-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIERKA",
        "first_name": "ROGER",
        "middle_name": "LELAND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "32033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7138610",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shell Rock, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.