Individual provider Active NPI

Michael Shane Skelton, M.A., CCC-A

  • Audiologist-Hearing Aid Fitter
  • Flagstaff, AZ
National Provider Identifier
1285845073
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
DA 1859 Issued in AZ
Practice address
327 McConnell Cir
BLDG.66 RM 327
Flagstaff, AZ 86011-0001
Phone
(928) 523-8110
NPI assigned
May 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X DA 1859 AZ Primary

Addresses

Primary practice location

327 McConnell Cir
BLDG.66 RM 327
Flagstaff, AZ 86011-0001

Mailing address

2641 N Fox Run Dr
Flagstaff, AZ 86004-7683
Phone (928) 526-0634

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100727000095 AZ Practitioner - Qualified Audiologist 5597898619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
At Still University, Arizona School of Dentistry & Oral HLTH, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

208 E Pine Knoll Dr
Flagstaff, AZ 86011-0001
Phone (928) 523-8110

824 S San Francisco St
Flagstaff, AZ 86011-0001
Phone (928) 523-2131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
DA 1859AZMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Az BD of Regents for on Behalf of Northern Az University CurrentSince Jul 1, 2009 Accepting new patients
Northern Arizona University Audiologist-Hearing Aid Fitter CurrentSince Jul 1, 2009 Accepting new patients

Locations

208 E Pne Knl Dr
Flagstaff, AZ 86011
Phone (928) 523-5122

912 Riordan Rd
Flagstaff, AZ 86011
Phone (928) 523-1695

Organizations & group practices 2

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285845073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2641 N FOX RUN DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860047683",
            "telephone_number": "928-526-0634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 MCCONNELL CIR",
            "address_2": "BLDG.66 RM 327",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860110001",
            "telephone_number": "928-523-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKELTON",
        "first_name": "MICHAEL",
        "middle_name": "SHANE",
        "credential": "M.A., CCC-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "AZ",
            "license": "DA 1859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.