Active NPI
Robert Skinner, D.V.M.
- Veterinarian
- Excelsior, MN
National Provider Identifier
1093137085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Veterinarian
- License
- 11579
- Practice address
- 19880 Waterford CT
Excelsior, MN 55331-7029 - Phone
- (952) 201-2902
- NPI assigned
- Jan 10, 2014
- Last updated
- Jan 29, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 11579 | MN | Primary |
Addresses
Primary practice location
19880 Waterford CT
Excelsior, MN 55331-7029
Mailing address
19880 Waterford CT
Excelsior, MN 55331-7029
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11579 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422489600000",
"number": "1093137085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19880 WATERFORD CT",
"city": "EXCELSIOR",
"state": "MN",
"postal_code": "553317029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19880 WATERFORD CT",
"city": "EXCELSIOR",
"state": "MN",
"postal_code": "553317029",
"telephone_number": "952-201-2902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKINNER",
"first_name": "ROBERT",
"credential": "D.V.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-01-10",
"last_updated": "2015-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "174M00000X",
"taxonomy_group": "",
"desc": "Veterinarian",
"state": "MN",
"license": "11579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Excelsior, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.