Individual provider Active NPI

Hunter Skoog, MD

  • Otolaryngology Physician
  • Longview, TX
National Provider Identifier
1184120495
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
U3655 Issued in TX
Practice address
912 Walnut Hill Dr
Longview, TX 75605-5052
Phone
(903) 291-6300
Fax
(903) 291-6305
NPI assigned
Apr 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AL
Otolaryngology Physician 207Y00000X U3655 TX Primary

Addresses

Primary practice location

912 Walnut Hill Dr
Longview, TX 75605-5052

Mailing address

912 Walnut Hill Dr
Longview, TX 75605-5052

Other practice location 1

625 19th Street South
Birmingham, AL 35249
Phone (205) 934-9777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230808004166 TX Practitioner - Otolaryngology 0547622508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Texas a & M University System, HSC, College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ryan M Guillory MD PAGroup PAC ID 1254608771, 6 clinicians

Practice addresses (Care Compare)

912 Walnut Hill Dr
Longview, TX 75605-5052
Phone (903) 212-9456

Hospital & facility affiliations

  • Longview Regional Medical Center Hospital, Longview, TX, CCN 450702
  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan M Guillory MD PA Otolaryngology CurrentSince Aug 9, 2023 Accepting new patients

Locations

709 Hollybrook Dr
Ste 5605
Longview, TX 75605
Phone (903) 291-6053

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1184120495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 WALNUT HILL DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 WALNUT HILL DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055052",
            "telephone_number": "903-291-6300",
            "fax_number": "903-291-6305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 19th Street South",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "35249",
            "country_code": "US",
            "telephone_number": "205-934-9777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKOOG",
        "first_name": "HUNTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "U3655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.