Organization Active NPI

Skabo Inc

Doing business as Copper Canyon Chiropractic

  • Chiropractor
  • Goodyear, AZ
National Provider Identifier
1043406515
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7049 Issued in AZ
Legal business name
SKABO INC
Doing business as
Copper Canyon Chiropractic
Practice address
1650 N Dysart Rd
Ste #1
Goodyear, AZ 85395-1116
Phone
(623) 925-9045
Fax
(623) 925-9047
NPI assigned
Sep 19, 2007
Last updated
Sep 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2007

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

Authorized official

Name
Dr. James Allen Skabo, DCNPI 1417048091
Title
President
Phone
(623) 925-9045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7049 AZ Primary

Addresses

Primary practice location

1650 N Dysart Rd
Ste #1
Goodyear, AZ 85395-1116

Mailing address

1650 N Dysart Rd
Ste #1
Goodyear, AZ 85395-1116
Phone (623) 925-9045

Other names 1

  • Copper Canyon Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040621001810 AZ Part B Supplier - Clinic/Group Practice 1658356951 Receives reassigned benefits from 1 practitioner
Practice locations: Goodyear, AZ

National Provider Directory

National Provider Directory

Locations

1650 N Dysart Rd
Ste 1
Goodyear, AZ 85395
Phone (623) 925-9045

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1043406515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 N DYSART RD",
            "address_2": "STE #1",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853951116",
            "telephone_number": "623-925-9045",
            "fax_number": "623-925-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 N DYSART RD",
            "address_2": "STE #1",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853951116",
            "telephone_number": "623-925-9045",
            "fax_number": "623-925-9047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKABO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "SKABO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-925-9045",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Copper Canyon Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.