Maurice Skillern, DMS-PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4131 Kirby Pkwy Ste 1
Memphis, TN 38115-6500

Phone

(706) 536-3272

Fax

(833) 903-2341

NPI assigned

Aug 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Physician Associate Interdisciplinary Clinic (Pain-C)

  • Physician Assistant
  • Memphis, TN
  • NPI 1407373210
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1073525903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 KIRBY PKWY STE 1",
            "address_2": "KIRBY-RAINES MEDICAL CENTER",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38115",
            "telephone_number": "901-305-6766",
            "fax_number": "833-903-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 KIRBY PKWY STE 1",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381156500",
            "telephone_number": "706-536-3272",
            "fax_number": "833-903-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKILLERN",
        "first_name": "MAURICE",
        "name_prefix": "Mr.",
        "credential": "DMS-PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q038355",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen Michael Sittnick, DO
• Sizewise Rentals
• Adriann Skeen
• James Andrew Skelton Sr., D.PH.
• Lacresha Skillern, PHARMD
• Ashley Skinner, DO
• Cayla Skinner, BCBA, LBA
• Robert B Skinner, MD
• Lisa Skirius
• Karly Madison Skolnik, PTA

• Physician Assistant in Memphis, TN
• Providers in Memphis, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.