Active NPI
Jill S Skinner, O.D.
- Optometrist
- Prospect, CT
National Provider Identifier
1184929705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 002562
- Practice address
- 279 Matthew St
Prospect, CT 06712-1417 - Phone
- (203) 232-5948
- NPI assigned
- Jan 12, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 002562 | CT | Primary |
Addresses
Primary practice location
279 Matthew St
Prospect, CT 06712-1417
Mailing address
279 Matthew St
Prospect, CT 06712-1417
Phone (203) 232-5948
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002562 | CT | MD | Intellectual & Developmental Disabilities Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294790400000",
"number": "1184929705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "279 MATTHEW ST",
"city": "PROSPECT",
"state": "CT",
"postal_code": "067121417",
"telephone_number": "203-232-5948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "279 MATTHEW ST",
"city": "PROSPECT",
"state": "CT",
"postal_code": "067121417",
"telephone_number": "203-232-5948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKINNER",
"first_name": "JILL",
"middle_name": "S",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-12",
"last_updated": "2011-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CT",
"license": "002562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prospect, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.