Individual provider Active NPI

Jamie Skipton, PT

  • Physical Therapist
  • Bemidji, MN
National Provider Identifier
1205354107
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10812 Issued in MN
Practice address
3835 Supreme CT NW Ste 2
Bemidji, MN 56601-4485
Phone
(218) 444-8280
Fax
(218) 444-8337
NPI assigned
Aug 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10812 MN Primary

Addresses

Primary practice location

3835 Supreme CT NW Ste 2
Bemidji, MN 56601-4485

Mailing address

3835 Supreme CT NW Ste 2
Bemidji, MN 56601-4485
Phone (218) 444-8280

Other names 1

  • Jamie Drevlow Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171016000758 MN Practitioner - Physical Therapist in Private Practice 0244506434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of North Dakota School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choice Therapy, P.a.Group PAC ID 7618022930, 39 clinicians

Practice addresses (Care Compare)

3835 Supreme CT NW
Suite 2
Bemidji, MN 56601-4485
Phone (218) 444-8280

Merit-based Incentive Payment System (MIPS)

Final score
83 of 100Reported as individual
Quality
80
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10812MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Choice Therapy, P.a. Physical Therapist CurrentSince Aug 23, 2017 Accepting new patients

Locations

118 Central St W
Bagley, MN 56621
Phone (218) 694-3030

3835 Supreme Ct NW
Ste 2
Bemidji, MN 56601
Phone (218) 441-5232

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": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205354107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 SUPREME CT NW STE 2",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014485",
            "telephone_number": "218-444-8280",
            "fax_number": "218-444-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3835 SUPREME CT NW STE 2",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014485",
            "telephone_number": "218-444-8280",
            "fax_number": "218-444-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIPTON",
        "first_name": "JAMIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2022-07-21",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "DREVLOW",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.