Individual provider Active NPI

Lee Taylor Skelton, DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Indianola, MS
National Provider Identifier
1033595509
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R877686 Issued in MS
Practice address
121 E Baker St
Indianola, MS 38751-2450
Phone
(662) 887-6000
NPI assigned
Aug 6, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R877686 MS Primary

Addresses

Primary practice location

121 E Baker St
Indianola, MS 38751-2450

Mailing address

706 W Gresham St
Indianola, MS 38751-2046
Phone (662) 931-2256

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160125000262 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 2264735364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Sunflower County HospitalGroup PAC ID 6709771637, 18 clinicians

Practice addresses (Care Compare)

121 E Baker St
Indianola, MS 38751-2450
Phone (662) 635-7210

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R877686MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
South Sunflower County Hospital Current Accepting new patients
South Sunflower County Hospital CurrentSince Oct 24, 2015 Accepting new patients
South Sunflower County Hospital CurrentSince Oct 24, 2015 Accepting new patients

Locations

121 E Baker St
Indianola, MS 38751
Phone (601) 887-3113

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1033595509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 W GRESHAM ST",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512046",
            "telephone_number": "662-931-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 E BAKER ST",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512450",
            "telephone_number": "662-887-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKELTON",
        "first_name": "LEE",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R877686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianola, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; 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.