Individual provider Active NPI

Mimi Renee Skocik, D.C.

  • Orthopedic Chiropractor
  • Dover, DE
National Provider Identifier
1225277437
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
F1-0000724 Issued in DE
Practice address
1111A S Governors Ave
Dover, DE 19904-6903
Phone
(302) 734-2225
Fax
(302) 734-2227
NPI assigned
Feb 11, 2009
Last updated
Jun 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC009994 PA
Chiropractor 111N00000X F1-0000724 DE
Orthopedic Chiropractor 111NX0800X F1-0000724 DE Primary

Addresses

Primary practice location

1111A S Governors Ave
Dover, DE 19904-6903

Mailing address

1111A S Governors Ave
Dover, DE 19904-6903
Phone (302) 734-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110127001006 DE Practitioner - Chiropractic 2062561350 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F1-0000724DEMDChiropractor
DC009994PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Better Life Chiropractic & Rehabilitation Center Orthopedic CurrentSince Apr 30, 2003 Accepting new patients

Locations

1111 S Governors Ave
Dover, DE 19904
Phone (302) 678-2272

1111 S Governors Ave
#A
Dover, DE 19904
Phone (302) 734-2225

2450 Market St
Upper Chichester, PA 19061
Phone (610) 494-2225

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1225277437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111A S GOVERNORS AVE",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199046903",
            "telephone_number": "302-734-2225",
            "fax_number": "302-734-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111A S GOVERNORS AVE",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199046903",
            "telephone_number": "302-734-2225",
            "fax_number": "302-734-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOCIK",
        "first_name": "MIMI",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-11",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC009994",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "DE",
            "license": "F1-0000724",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "DE",
            "license": "F1-0000724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.