Audrey Mie Park-Skinner

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

35484 Issued in MN

Practice address

400 E 3Rd St
Duluth, MN 55805-1951

Phone

(218) 786-8364

NPI assigned

Jul 9, 2006

Last updated

May 9, 2011By the provider in NPPES

Sex

Female

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 2

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

General Surgery

Education

Temple University School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health St Mary's Medical Center Hospital, Duluth, MN, CCN 240002

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Duluth Clinic LTD

  dba Essentia Health Cloquet Clinic

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment Care Compare group NPD
• Deer River Healthcare Center, Inc.

  dba Essentia Health Deer River

  • Critical Access Hospital
  • Deer River, MN
  • NPI 1225049018
  Medicare reassignment NPD
• Range Regional Health Services

  • Clinic/Center
  • Hibbing, MN
  • NPI 1669569265
  Medicare reassignment NPD
• St. Marys Regional Health Center

  dba Essentia Health St. Mary's- Detroit Lakes

  • Rural Acute Care Hospital
  • Detroit Lakes, MN
  • NPI 1679561088
  Medicare reassignment NPD
• St. Mary's Hospital of Superior

  dba Essentia Health St. Mary's Hospital Superior

  • Critical Access Hospital
  • Superior, WI
  • NPI 1083657886
  Medicare reassignment NPD
• Deer River Healthcare Center, Inc

  dba Essentia Health Deer River Clinic

  • Critical Access Hospital Clinic/Center
  • Deer River, MN
  • NPI 1518904887
  NPD
• Deer River Healthcare Center, Inc.

  dba Essentia Health Deer River

  • Medicare Defined Swing Bed Hospital Unit
  • Deer River, MN
  • NPI 1215041199
  NPD
• Range Regional Health Services

  • General Acute Care Hospital
  • Hibbing, MN
  • NPI 1356321699
  NPD
• Range Regional Health Services

  dba HealthLine Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • International Falls, MN
  • NPI 1710954821
  NPD
• St Mary's Regional Health Center

  dba Essentia Health St. Mary's-Frazee Clinic

  • Rural Health Clinic/Center
  • Frazee, MN
  • NPI 1902364482
  NPD
• St Marys Regional Health Center

  dba Essentia Health Park Rapids Hwy 34 Clinic

  • Rural Health Clinic/Center
  • Park Rapids, MN
  • NPI 1730706656
  NPD
• The Duluth Clinic, LTD

  dba Essentia Health Duluth Clinic

  • Multi-Specialty Clinic/Center
  • Duluth, MN
  • NPI 1245278209
  NPD

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

• St Marys Medical Center

  dba Essentia Health St Marys Medical Center

  • General Acute Care Hospital
  • Duluth, MN
  • NPI 1457393035
  Care Compare affiliation
• St. Marys Medical Center

  dba SMMC Life Flight

  • Air Ambulance
  • Duluth, MN
  • NPI 1841359478

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304899200000",
    "number": "1083647499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK-SKINNER",
        "first_name": "AUDREY",
        "middle_name": "MIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2011-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "35484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31795100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "616700400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan J Pannkuk, CRNA
• Jasmine Pape
• Jeneen Elizabeth Paplior
• Bhernee Abada Paragas, P.T.
• Megan Marie Paris, PSYD, L.P.
• Rachel Parmeter
• Jacob Parsons
• Erin Partyka
• Courtney Lynn Passint
• Hayley Starr Patel, NP

• Surgery Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.
• 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.