Active NPI
Roger A Skindell, DO
- Family Medicine Physician
- Lapeer, MI
National Provider Identifier
1114918448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5101009274
- Practice address
- 1254 N Main St
Lapeer, MI 48446-1343 - Phone
- (810) 664-4531
- Fax
- (810) 667-7337
- NPI assigned
- Nov 4, 2005
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101009274 | MI | Primary |
Addresses
Primary practice location
1254 N Main St
Lapeer, MI 48446-1343
Mailing address
401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-1000
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080D410020 | Other | MA | BLUE CROSS BLUE SHIELD |
| 080D410020 | Other | MI | BLUE CHOICE POS |
| 3303942 | Medicaid | MI | |
| B43804 | Other | MI | HEALTH NET FEDERAL SERV |
| 201552 | Other | MI | HEALTH ADVANTAGE NETWORK |
| 2999842001 | Other | MI | CIGNA |
| 080095523 | Other | MI | METRAHEALTH |
| 080D410020 | Other | MI | COMMUNITY BLUE |
| 5440026 | Other | MI | HEALTH PLUS |
| B43804 | Other | MI | HEALTH ALLIANCE PLAN |
| 080D410020 | Other | MI | BLUE CARE NETWORK |
| 4120730 | Other | MA | AETNA |
| 201552 | Other | MI | MCLAREN HEALTH PLAN |
| C1538 | Other | MI | MCARE |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101009274 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McLaren Medical Group | Current | Accepting new patients |
Locations
401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000
Organizations & group practices 1
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.
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- Burton, MI
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350345600000",
"number": "1114918448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 S BALLENGER HWY",
"city": "FLINT",
"state": "MI",
"postal_code": "485323638",
"telephone_number": "810-342-1000",
"fax_number": "810-342-1590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1254 N MAIN ST",
"city": "LAPEER",
"state": "MI",
"postal_code": "484461343",
"telephone_number": "810-664-4531",
"fax_number": "810-667-7337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKINDELL",
"first_name": "ROGER",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-04",
"last_updated": "2012-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101009274",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "080D410020",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE POS",
"identifier": "080D410020",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3303942",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET FEDERAL SERV",
"identifier": "B43804",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ADVANTAGE NETWORK",
"identifier": "201552",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2999842001",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "METRAHEALTH",
"identifier": "080095523",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMUNITY BLUE",
"identifier": "080D410020",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLUS",
"identifier": "5440026",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE PLAN",
"identifier": "B43804",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE NETWORK",
"identifier": "080D410020",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4120730",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCLAREN HEALTH PLAN",
"identifier": "201552",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCARE",
"identifier": "C1538",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lapeer, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.