Jonathan Josef Skonicki, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

30198 Issued in AL

Practice address

3701 Loop Rd
Tuscaloosa VA Medical Center,
Tuscaloosa, AL 35404-5015

Phone

(205) 554-2000

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1013053172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 LOOP RD",
            "address_2": "TUSCALOOSA VA MEDICAL CENTER,",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045015",
            "telephone_number": "205-554-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 LOOP RD",
            "address_2": "TUSCALOOSA VA MEDICAL CENTER,",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045015",
            "telephone_number": "205-554-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKONICKI",
        "first_name": "JONATHAN",
        "middle_name": "JOSEF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "24572",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "30198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Psychiatry Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.