Peter Gering Skupeko, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2548 Issued in MN

Practice address

1325 Eldridge Ave W
Roseville, MN 55113-5917

Phone

(651) 639-1615

Fax

(651) 639-1615

NPI assigned

Aug 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1023202561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 HAMLINE AVE N",
            "address_2": "SUITE 215",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551135009",
            "telephone_number": "651-639-1625",
            "fax_number": "651-639-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 ELDRIDGE AVE W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551135917",
            "telephone_number": "651-639-1615",
            "fax_number": "651-639-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKUPEKO",
        "first_name": "PETER",
        "middle_name": "GERING",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "2548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Singh, RPT
• Sisters Assistant Living Care LLC
• Eric Skime
• Aimee Skrei
• Michael S Skulski, MD
• Sarah Grace Slinger
• Evelyn Lidia Slomka, M.D.
• Brenda Linette Smieja
• Andrea Jolene Smith, RN
• Douglas Smith, M.D.

• Physical Therapist in Roseville, MN
• Providers in Roseville, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.