Individual provider Active NPI

William Henry Skon, D.C.

  • Chiropractor
  • Saint Paul, MN
National Provider Identifier
1013008762
Registry record updated Sep 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2175 Issued in MN
Practice address
1567 Selby Ave
Saint Paul, MN 55104-6304
Phone
(651) 644-3900
Fax
(651) 644-8969
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2175 MN Primary

Addresses

Primary practice location

1567 Selby Ave
Saint Paul, MN 55104-6304

Mailing address

1567 Selby Ave
Saint Paul, MN 55104-6304
Phone (651) 644-3900

Other identifiers 2

IdentifierTypeStateIssuer
066910000MedicaidMN
DP2418OtherMNRAILROAD MEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050310000898 MN Practitioner - Chiropractic 4486608536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

856 Raymond Ave
Suite C
Saint Paul, MN 55114-1598
Phone (651) 644-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Skon Chiropractic PA Chiropractor CurrentSince Apr 1, 1995 Accepting new patients

Locations

856 Raymond Ave
Ste C
Saint Paul, MN 55114
Phone (651) 644-3900

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1013008762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1567 SELBY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046304",
            "telephone_number": "651-644-3900",
            "fax_number": "651-644-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1567 SELBY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046304",
            "telephone_number": "651-644-3900",
            "fax_number": "651-644-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKON",
        "first_name": "WILLIAM",
        "middle_name": "HENRY",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066910000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DP2418",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.