Individual provider Active NPI

Sandra Lane Skipper, AU.D.

  • Audiologist
  • Seneca, SC
National Provider Identifier
1245309053
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
465 Issued in SC
Practice address
10239 Clemson Blvd
Suite 170
Seneca, SC 29678-0861
Phone
(864) 888-8865
Fax
(864) 888-3838
NPI assigned
Nov 7, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 465 SC Primary

Addresses

Primary practice location

10239 Clemson Blvd
Suite 170
Seneca, SC 29678-0861

Mailing address

10239 Clemson Blvd
Suite 170
Seneca, SC 29678-0861
Phone (864) 888-8865

Other identifiers 1

IdentifierTypeStateIssuer
GP4340MedicaidSC

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

LicenseStateTypeSpecialty
465SCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate ENT Associates, P.a. Past Accepting new patients
BBS Hearing Services LLC Audiologist PastSince Oct 1, 2005 Accepting new patients

Organizations & group practices 3

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1245309053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10239 CLEMSON BLVD",
            "address_2": "SUITE 170",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296780861",
            "telephone_number": "864-888-8865",
            "fax_number": "864-888-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10239 CLEMSON BLVD",
            "address_2": "SUITE 170",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296780861",
            "telephone_number": "864-888-8865",
            "fax_number": "864-888-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIPPER",
        "first_name": "SANDRA",
        "middle_name": "LANE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "SC",
            "license": "465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4340",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.