Emily Ellen Skibo, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.009973 Issued in IL

Practice address

4200 Ilberry Rd
Mount Vernon, IL 62864-6748

Phone

(618) 242-6338

Fax

(618) 242-0465

NPI assigned

Jul 2, 2007

Last updated

Mar 17, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Skibo Family Eyecare LLC

  • Optometrist
  • Mount Vernon, IL
  • NPI 1184984163
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1124225180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 ILBERRY RD",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646748",
            "telephone_number": "618-242-6338",
            "fax_number": "618-242-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 ILBERRY RD",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646748",
            "telephone_number": "618-242-6338",
            "fax_number": "618-242-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIBO",
        "first_name": "EMILY",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.009973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00650602 CA2196",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009973",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie L Simonton-Smith, M.D.
• Bria Sims
• Naga Srinivas Sirikonda, M.D
• Olga Mary Skelly, N/A
• Skibo Family Eyecare LLC
• Skills 4 Life OT, LLC
• Skin Care Center of Southern Il LLC
• Sleep & Neurology Center of Southern Illinois, LLC
• Aiping Smith, M.D.
• Bonnie Smith, RN

• Optometrist in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.