Skilled Medpros

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD074428-L Issued in PA

Legal business name

SKILLED MEDPROS

Practice address

222 Fallen Timber Dr
Du Bois, PA 15801-5808

Phone

(814) 591-2495

Fax

(866) 832-1744

NPI assigned

Sep 17, 2014

Last updated

Sep 17, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Timothy Clark Simpson, M.D.

Title

M.D.

Phone

(814) 591-2495

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410912000000",
    "number": "1215339601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 FALLEN TIMBER DR",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158015808",
            "telephone_number": "814-591-2495",
            "fax_number": "866-832-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 FALLEN TIMBER DR",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158015808",
            "telephone_number": "814-591-2495",
            "fax_number": "866-832-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKILLED MEDPROS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-17",
        "last_updated": "2014-09-17",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "CLARK",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "814-591-2495",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD074428-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward J. Shok, D.M.D.
• Mikayla Marie Shute, DO
• W. John Siar, MD
• Nicholas E Sipes, PA-C
• Brady Martin Skiles, PA-C
• Zachary James Sloan, OD
• Grace Smakosz, PA-C
• John Thomas Smelko, D.M.D.
• Melissa Ann Smeltzer-Wolfe, LCSW
• Stacey E Smiley, CRNP

• Family Medicine Physician in Du Bois, PA
• Providers in Du Bois, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.