Individual provider Active NPI

Stephanie Carol Skaggs, AU.D

  • Audiologist
  • Madison, TN
National Provider Identifier
1144904947
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2150 Issued in TN
Practice address
1994 Gallatin Pike N Ste 200
Madison, TN 37115-2024
Phone
(615) 851-9005
Fax
(615) 851-9007
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 2150 TN
Audiologist 231H00000X 2150 TN Primary

Addresses

Primary practice location

1994 Gallatin Pike N Ste 200
Madison, TN 37115-2024

Mailing address

1994 Gallatin Pike N Ste 200
Madison, TN 37115-2024
Phone (615) 851-9005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250204002970 CA Practitioner - Qualified Audiologist 5698128296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jason Roos DO a Professional Medical CorporationGroup PAC ID 4789082561, 10 clinicians

Practice addresses (Care Compare)

1700 W Walnut Ave
Suite a
Visalia, CA 93277-6233
Phone (559) 409-4720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2150TNMDPhysical Therapy Assistant
10815CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jason Roos DO a Professional Medical Corporation CurrentSince Nov 30, 2024 Accepting new patients

Locations

1680 E Herndon Ave
Ste 102
Fresno, CA 93720
Phone (559) 401-6058

3553 Camino Mira Costa
Ste D
San Clemente, CA 92672
Phone (949) 200-7737

805 W Acequia Ave
Ste 1B
Visalia, CA 93291
Phone (559) 409-4720

1700 W Walnut Ave
#A
Visalia, CA 93277
Phone (559) 409-4720

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.

NPI Registry JSON

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1144904947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1994 GALLATIN PIKE N STE 200",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371152024",
            "telephone_number": "615-851-9005",
            "fax_number": "615-851-9007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1994 GALLATIN PIKE N STE 200",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371152024",
            "telephone_number": "615-851-9005",
            "fax_number": "615-851-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKAGGS",
        "first_name": "STEPHANIE",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TN",
            "license": "2150",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TN",
            "license": "2150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.