Active NPI
Skyler Fluitt
- Recreation Therapist
- Dallas, TX
National Provider Identifier
1093380719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 62602
- Practice address
- 4500 S Lancaster Rd
Dallas, TX 75216-7167 - Phone
- (214) 857-1794
- NPI assigned
- May 25, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 62602 | TX | Primary |
Addresses
Primary practice location
4500 S Lancaster Rd
Dallas, TX 75216-7167
Mailing address
12354 Orloff Dr
Rhome, TX 76078-6065
Phone (940) 366-2889
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 |
|---|---|---|---|
| 62602 | TX | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621900800000",
"number": "1093380719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12354 ORLOFF DR",
"city": "RHOME",
"state": "TX",
"postal_code": "760786065",
"telephone_number": "940-366-2889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 S LANCASTER RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752167167",
"telephone_number": "214-857-1794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLUITT",
"first_name": "SKYLER",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-25",
"last_updated": "2021-05-25",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "TX",
"license": "62602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.