David Skordelis

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

22262 Issued in AK

Practice address

710 3Rd Ave
Fairbanks, AK 99701-4455

Phone

(907) 452-4222

NPI assigned

Jul 1, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Interior AIDS Association

  • Methadone Clinic
  • Fairbanks, AK
  • NPI 1306483755
  NPD
• Interior AIDS Association

  • Community/Behavioral Health Agency
  • Fairbanks, AK
  • NPI 1881713261
  NPD (past)

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

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1124751722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71248",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997071248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 3RD AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014455",
            "telephone_number": "907-452-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKORDELIS",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-01",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "22262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Singleton
• Theodora Nastasia Sipary, BHA
• Ernie Sipes
• Melanie Ann Sipes, CDM
• Simi Skipps
• Natalya Skott
• Rachel Valentine Sladky, DDS
• Andrea A Slater-Williams
• Justine Slater
• Angelina M Sletten

• Registered Nurse in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Registered Nurse in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.