Individual provider Active NPI

Martin Usher Skulskie, M.D.

  • Gastroenterology Physician
  • Burlington, NC
National Provider Identifier
1184739484
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
99-01033 Issued in NC
Practice address
1234 Huffman Mill Rd
Burlington, NC 27215-8700
Phone
(336) 538-1234
Fax
(336) 584-6811
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 99-01033 NC Primary

Addresses

Primary practice location

1234 Huffman Mill Rd
Burlington, NC 27215-8700

Mailing address

PO Box 1717
Burlington, NC 27216-1717
Phone (336) 538-1234

Other identifiers 1

IdentifierTypeStateIssuer
891211LMedicaidNC

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 Medicine

State licenses

LicenseStateTypeSpecialty
99-01033NCMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1184739484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1717",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272161717",
            "telephone_number": "336-538-1234",
            "fax_number": "336-584-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 HUFFMAN MILL RD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158700",
            "telephone_number": "336-538-1234",
            "fax_number": "336-584-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKULSKIE",
        "first_name": "MARTIN",
        "middle_name": "USHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "99-01033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891211L",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.